Healthcare Provider Details

I. General information

NPI: 1215513981
Provider Name (Legal Business Name): ALEXANDRIA YOUNG MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 MARKET ST FL 8
PHILADELPHIA PA
19104-5509
US

IV. Provider business mailing address

3701 MARKET ST FL 8
PHILADELPHIA PA
19104-5509
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-6100
  • Fax: 215-662-3535
Mailing address:
  • Phone: 215-662-6100
  • Fax: 215-662-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberMD489290
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: