Provider Demographics
NPI:1306837000
Name:YOUNG, CONSTANCE A (MD)
Entity Type:Individual
Prefix:DR
First Name:CONSTANCE
Middle Name:A
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28082
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-8082
Mailing Address - Country:US
Mailing Address - Phone:212-987-3100
Mailing Address - Fax:212-987-1799
Practice Address - Street 1:255 GREENWICH ST STE 510
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2422
Practice Address - Country:US
Practice Address - Phone:212-298-2720
Practice Address - Fax:212-298-2759
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY160390207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00695941Medicaid
A60125Medicare UPIN
NY00695941Medicaid
G100000410Medicare Oscar/Certification
NY502C31Medicare ID - Type Unspecified
NY331952Medicare Oscar/Certification
NYW6L111Medicare Oscar/Certification