Provider Demographics
NPI:1619938586
Name:YOUNG, SUSAN M (MD)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-1977
Practice Address - Street 1:370 LUNENBURG ST
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-4541
Practice Address - Country:US
Practice Address - Phone:978-345-1040
Practice Address - Fax:978-348-1286
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2021-03-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA79019207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042472266OtherRAILROAD MEDICARE
7021289OtherAETNA US HEALTHCARE
0100298OtherEVERCARE
3130690OtherMEDICAID WELFARE
042472266OtherPRIVATE HEALTHCARE SYSTEM
26971OtherCHILDRENS MEDICAL SECURIT
784210OtherMVP HEALTH CARE
J14926OtherBLUE CARE ELECT
042472266OtherHEALTHCARE VALUE MANAGEME
1150399OtherHARVARD PILGRIM HEALTHCAR
2759750OtherCIGNA HEALTH PLAN
MA3130690Medicaid
9901113OtherFALLON COMMUNITY HEALTH P
J14926OtherMEDICARE B
J14926OtherBLUE SHIELD HMO BLUE
042472266OtherONE HEALTH PLAN
26971OtherHEALTHY START
J14926OtherBLUE SHIELD INDEMNITY
7021289OtherAETNA US HEALTHCARE
9901113OtherFALLON COMMUNITY HEALTH P