Provider Demographics
NPI:1235272766
Name:YOUNG, ALLAN GRAYSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:GRAYSON
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:676 FRONT ST
Mailing Address - Street 2:APT. H
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4504
Mailing Address - Country:US
Mailing Address - Phone:516-539-1768
Mailing Address - Fax:516-483-1245
Practice Address - Street 1:250 FULTON AVE
Practice Address - Street 2:510
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3917
Practice Address - Country:US
Practice Address - Phone:516-483-9020
Practice Address - Fax:516-483-1245
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2009-03-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY082894207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY208639OtherWORKMEN'S COMP
NY00431672Medicaid
NY0025699OtherGHI
NY132561OtherEMPIRE BLUE CROSSSHIELD
NY001642OtherCOMMERCIAL
NY0025699OtherGHI
NY132561OtherEMPIRE BLUE CROSSSHIELD