Provider Demographics
NPI:1437161114
Name:YOUNG, CLIFFORD URIAS (MD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:URIAS
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1954 ROCKAWAY PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-5506
Mailing Address - Country:US
Mailing Address - Phone:718-209-8002
Mailing Address - Fax:718-209-4744
Practice Address - Street 1:1954 ROCKAWAY PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-5506
Practice Address - Country:US
Practice Address - Phone:718-209-8002
Practice Address - Fax:718-209-4744
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186552207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01845610Medicaid
NY01845610Medicaid
NY81H20EP951Medicare PIN