MEDICARE: DR. BYRON MARK ANTHONY YOUNG M.D.

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	2084P0800X	Psychiatry Physician	136547	CA
2	2084P0800X	Psychiatry Physician	263352	NY
3	2084P0804X	Child & Adolescent Psychiatry Physician	136547	CA
4	2084P0804X	Child & Adolescent Psychiatry Physician	263352	NY

General Provider Information

NPI Number	:	1932417219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BYRON MARK ANTHONY YOUNG M.D.

Provider Business Mailing Address
First Line	:	10 CITY PT APT 45B
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-7011
Country	:	US
Telephone Number	:	504-858-8236
Fax Number	:

Provider Business Practice Location Address
First Line	:	425 E 25TH ST FL 8
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10010-2547
Country	:	US
Telephone Number	:	504-858-8236
Fax Number	:

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

Provider Enumeration Date	:	09/20/2010
Last Update Date	:	03/07/2023

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