Provider Demographics
NPI:1326325796
Name:YOUNG, CHRISTOPHER (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 FRANCIS ST
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02451-4308
Mailing Address - Country:US
Mailing Address - Phone:512-659-3318
Mailing Address - Fax:
Practice Address - Street 1:42 FRANCIS ST
Practice Address - Street 2:UNIT 1
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-4308
Practice Address - Country:US
Practice Address - Phone:512-659-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-13
Last Update Date:2011-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH26534183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAPH26534OtherRPH LICENSE