Provider Demographics
NPI:1659539443
Name:YOUNG, ALEXIS LIVINGSTON (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:LIVINGSTON
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 1:277 FOREST AVENUE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-523-9506
Mailing Address - Fax:
Practice Address - Street 1:277 FOREST AVENUE
Practice Address - Street 2:SUITE 207
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-523-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-28
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY249723207N00000X, 207ND0900X
NJ25MA08905500207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400051330Medicare UPIN
NJ225226CUQMedicare UPIN