Healthcare Provider Details

I. General information

NPI: 1831496660
Provider Name (Legal Business Name): BRUCE K. YOUNG, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 02/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 1ST AVE 5G
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

530 1ST AVE 5G
NEW YORK NY
10016-6402
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-6359
  • Fax: 212-263-6329
Mailing address:
  • Phone: 212-263-6359
  • Fax: 212-263-6329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD094388
License Number StateNY

VIII. Authorized Official

Name: DR. BRUCE K YOUNG
Title or Position: OWNER
Credential: M.D.
Phone: 212-263-6359