Provider Demographics
NPI:1518276468
Name:YOUNG, LORRAINE (RPH)
Entity Type:Individual
Prefix:
First Name:LORRAINE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1560 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3521
Mailing Address - Country:US
Mailing Address - Phone:732-493-1212
Mailing Address - Fax:732-695-1419
Practice Address - Street 1:1560 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-3521
Practice Address - Country:US
Practice Address - Phone:732-493-1212
Practice Address - Fax:732-695-1419
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02090900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist