Provider Demographics
NPI:1558670224
Name:SALLY SIR-YEE YOUNG MD PLC
Entity Type:Organization
Organization Name:SALLY SIR-YEE YOUNG MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:S
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-348-1700
Mailing Address - Street 1:46325 W 12 MILE RD # 390
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2456
Mailing Address - Country:US
Mailing Address - Phone:248-348-1700
Mailing Address - Fax:248-348-1707
Practice Address - Street 1:46325 W 12 MILE RD # 390
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2456
Practice Address - Country:US
Practice Address - Phone:248-348-1700
Practice Address - Fax:248-348-1707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301063449208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty