MEDICARE: DR. ANNAMARIE YOUNG D.O.

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
1	207Q00000X	Family Medicine Physician	25MB036381	NJ

General Provider Information

NPI Number	:	1548374036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANNAMARIE YOUNG D.O.

Provider Business Mailing Address
First Line	:	4204 LANDIS AVE
Second Line	:
City	:	SEA ISLE CITY
State	:	NJ
Zip	:	08243-1922
Country	:	US
Telephone Number	:	609-263-7111
Fax Number	:

Provider Business Practice Location Address
First Line	:	4204 LANDIS AVE
Second Line	:
City	:	SEA ISLE CITY
State	:	NJ
Zip	:	08243-1922
Country	:	US
Telephone Number	:	609-263-7111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	07/08/2007

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