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General NPI Number Information
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NPI Number | 1790927929
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Entity Type | Individual
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Provider Name | JOHN GERALD YOUNG M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/02/2009
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Last Update Date | 04/02/2009
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Provider Practice Location Address
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Address Line | 16 1/2 EAST 74TH ST.
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-472-1862
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Fax | 212-472-3858
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Provider Business Mailing Address
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Address Line | 16 1/2 EAST 74TH ST.
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City | NEW YORK
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State | NY
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Zip | 10021
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Country | US
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Telephone | 212-472-1862
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Fax | 212-472-3858
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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 | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number | 112345-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084B0002X
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Taxonomy Name | Obesity Medicine (Psychiatry & Neurology) Physician
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License Number | 017358
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License Number State | CT
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