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NPI Code Detail

MEDICARE: JAIME ANNE YOUNG ATC

MEDICARE:   JAIME ANNE YOUNG  ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1396760377
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAIME ANNE YOUNG ATC
Provider Business Mailing Address
First Line : 990 HOPE ST APT 3B
Second Line :
City : STAMFORD
State : CT
Zip : 06907-2215
Country : US
Telephone Number : 203-644-8554
Fax Number :
Provider Business Practice Location Address
First Line : 650 WEST AVE
Second Line :
City : NORWALK
State : CT
Zip : 06850-4020
Country : US
Telephone Number : 203-852-9903
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2006
Last Update Date : 07/08/2007

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Directions to “ JAIME ANNE YOUNG ATC” Practice Location

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