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General NPI Number Information
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NPI Number | 1528291903
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Entity Type | Individual
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Provider Name | HYE YOUNG IM NP-C
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Gender | Female
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Dates
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Enumeration Date | 09/01/2009
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 20 WALL ST
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City | BURLINGTON
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State | MA
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Zip | 01803-4758
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Country | US
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Telephone | 781-221-2600
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Fax |
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Provider Business Mailing Address
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Address Line | 15 BELKNAP ST UNIT 2
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City | SOMERVILLE
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State | MA
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Zip | 02144-1515
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Country | US
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Telephone | 602-568-1795
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | A0808297
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 260340
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License Number State | MA
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