Provider Demographics
NPI:1376550004
Name:YOUNG, DONALD R (PHARM)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:414 BEAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-2501
Mailing Address - Country:US
Mailing Address - Phone:914-769-9047
Mailing Address - Fax:914-769-9047
Practice Address - Street 1:414 BEAR RIDGE RD
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-2501
Practice Address - Country:US
Practice Address - Phone:914-769-9047
Practice Address - Fax:914-769-9047
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY21582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist