Provider Demographics
NPI:1487659975
Name:YUNG, RAYMOND L (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:L
Last Name:YUNG
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 1:217 GRAND STREET
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4286
Mailing Address - Country:US
Mailing Address - Phone:212-625-8069
Mailing Address - Fax:212-431-8246
Practice Address - Street 1:217 GRAND STREET
Practice Address - Street 2:6TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4286
Practice Address - Country:US
Practice Address - Phone:212-625-8069
Practice Address - Fax:212-431-8246
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185578207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01888215Medicaid
NY113501469YU01OtherCARE PLUS
NY010185578NY01OtherANTHEM
NY185578-A20OtherHEALTHFIRST
NY185578-A31Other1199NBF
NY2200742OtherAETNA HMO
NY2C7453OtherHEALTH NET
NYYR5578OtherATLANTIS HEALTH PLAN
NY000000089754OtherGHI HMO
NY1000036961OtherAFFINITY HEALTH PLAN
NY113501469OtherGREAT-WEST HEALTHCARE
NYCS1040OtherOXFORD HEALTH PLAN
NY0600362OtherGHI
NY113501469OtherUNITED HEALTHCARE
NY177890101OtherHEALTH PLUS
NY4655590OtherAETNA PPO
NY113501469OtherHUMANA
NY9422652011OtherCIGNA