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General NPI Number Information
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NPI Number | 1477175966
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Entity Type | Organization
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Legal Business Name | YOUNG SKIN
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 123 HIGH RIDGE RD
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City | STAMFORD
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State | CT
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Zip | 06905-3811
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Country | US
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Telephone | 475-400-9455
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Fax | 952-209-9802
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Provider Business Mailing Address
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Address Line | 54 BRUCE PARK DR
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City | GREENWICH
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State | CT
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Zip | 06830-7202
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Country | US
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Telephone | 203-952-7747
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SARYNA PUTMAN YOUNG
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Credential | MD
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Telephone | 203-952-7747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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