Healthcare Provider Details

I. General information

NPI: 1861429656
Provider Name (Legal Business Name): GIA D YOUNGS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SENECA ST
ONEIDA NY
13421-2668
US

IV. Provider business mailing address

27 OSWEGO ST
CAMDEN NY
13316-1030
US

V. Phone/Fax

Practice location:
  • Phone: 315-363-1345
  • Fax: 315-363-9243
Mailing address:
  • Phone: 315-245-1452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF333083
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: