Healthcare Provider Details

I. General information

NPI: 1366541831
Provider Name (Legal Business Name): ALAN J YOUNG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 10/13/2022
Certification Date: 10/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 W MAIN ST
TARRYTOWN NY
10591-3674
US

IV. Provider business mailing address

68 SOUTH SERVICE ROAD SUITE 350
MELVILLE NY
11747
US

V. Phone/Fax

Practice location:
  • Phone: 914-681-0600
  • Fax:
Mailing address:
  • Phone: 516-945-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number140238
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: