=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811961766
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | YOUNGHEE J LIMB M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2006
-----------------------------------------------------
Last Update Date | 11/04/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 79 MIDDLEVILLE RD NORTHPORT VAMC
-----------------------------------------------------
City | NORTHPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11768-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-261-4400
-----------------------------------------------------
Fax | 631-266-6030
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 79 MIDDLEVILLE RD
-----------------------------------------------------
City | NORTHPORT
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11768-2200
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-261-4400
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | 160927
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------