Provider Demographics
NPI:1609220763
Name:YOUNG, ARI SAMUEL
Entity Type:Individual
Prefix:
First Name:ARI
Middle Name:SAMUEL
Last Name:YOUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 646
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-2222
Mailing Address - Fax:
Practice Address - Street 1:33 OVERLOOK RD STE 210
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3562
Practice Address - Country:US
Practice Address - Phone:908-522-5040
Practice Address - Fax:908-522-5041
Is Sole Proprietor?:No
Enumeration Date:2016-04-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11404000207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology