Provider Demographics
NPI:1619969821
Name:YOUNG, DEBORAH A (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
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 1:730 S HANOVER ST
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7520
Mailing Address - Country:US
Mailing Address - Phone:610-323-6835
Mailing Address - Fax:610-323-4154
Practice Address - Street 1:730 S HANOVER ST
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7520
Practice Address - Country:US
Practice Address - Phone:610-323-6835
Practice Address - Fax:610-323-4154
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030419E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA039575Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
PAC28367Medicare UPIN