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General NPI Number Information
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NPI Number | 1891265443
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Entity Type | Individual
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Provider Name | CAROLYN TE YOUNG MD
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Gender | Female
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Dates
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Enumeration Date | 11/27/2018
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 1320 NARRAGANSETT BLVD
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City | CRANSTON
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State | RI
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Zip | 02905
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Country | US
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Telephone | 401-443-6159
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 NARRAGANSETT BLVD
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City | CRANSTON
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State | RI
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Zip | 02905-5142
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Country | US
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Telephone | 401-461-3006
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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 | 207ZP0105X
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Taxonomy Name | Clinical Pathology/Laboratory Medicine Physician
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License Number | MD8912
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | MD8912
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 278133
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License Number State | MA
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