Provider Demographics
NPI:1558452367
Name:YOUNG, CHRISTINE (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 MERRIMACK ST STE 9
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-1764
Mailing Address - Country:US
Mailing Address - Phone:978-655-6652
Mailing Address - Fax:978-655-6653
Practice Address - Street 1:360 MERRIMACK ST STE 9
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-1764
Practice Address - Country:US
Practice Address - Phone:978-655-6652
Practice Address - Fax:978-655-6653
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12725207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30205369Medicaid
NH30205369Medicaid
NH139833Medicare UPIN