MEDICARE: REBECCA BROWN-YOUNG PMHNP

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	163WP0808X	Psychiatric/Mental Health Registered Nurse	472010	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	F401827	NY

General Provider Information

NPI Number	:	1588069348
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA BROWN-YOUNG PMHNP

Provider Business Mailing Address
First Line	:	10484 MAIN ST
Second Line	:
City	:	NORTH COLLINS
State	:	NY
Zip	:	14111-9409
Country	:	US
Telephone Number	:	716-337-3056
Fax Number	:	716-337-3056

Provider Business Practice Location Address
First Line	:	10484 MAIN ST
Second Line	:
City	:	NORTH COLLINS
State	:	NY
Zip	:	14111-9409
Country	:	US
Telephone Number	:	716-680-7163
Fax Number	:	716-680-7163

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

Provider Enumeration Date	:	10/22/2014
Last Update Date	:	03/19/2025

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