Healthcare Provider Details

I. General information

NPI: 1952683872
Provider Name (Legal Business Name): LINDA DAWN YOUNG NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2011
Last Update Date: 09/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

624 MCCLELLAN ST
SCHENECTADY NY
12304-1020
US

IV. Provider business mailing address

45 SANDALWOOD LN
GLENVILLE NY
12302-5424
US

V. Phone/Fax

Practice location:
  • Phone: 518-347-5113
  • Fax:
Mailing address:
  • Phone: 518-399-6319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF336771-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: