Provider Demographics
NPI:1477739464
Name:YOUNG, LINDA (LAC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1070 PARK AVE STE 1E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:242 E 72ND ST
Practice Address - Street 2:15B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4574
Practice Address - Country:US
Practice Address - Phone:646-584-9311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-21
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3447171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist