Provider Demographics
NPI:1336112994
Name:YOUNG, PATRICIA A (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
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 1:2130 HIGHWAY 35
Mailing Address - Street 2:SUITE 213B
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1010
Mailing Address - Country:US
Mailing Address - Phone:732-974-8668
Mailing Address - Fax:
Practice Address - Street 1:2130 HIGHWAY 35
Practice Address - Street 2:SUITE 213B
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1010
Practice Address - Country:US
Practice Address - Phone:732-974-8668
Practice Address - Fax:732-974-1078
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA04102100207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP400879OtherOXFORD
NJ1K5561OtherHEALTHNET
NJ6306101Medicaid
NJ110172633OtherRAILROAD MEDICARE
NJ223360408-031OtherQUALCARE
NJP400879OtherOXFORD
NJ6306101Medicaid