Provider Demographics
NPI:1780858803
Name:YOUNG, KATE M (PA)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:M
Last Name:YOUNG
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:M
Other - Last Name:NEIGHBORS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:523 E 72ND ST
Mailing Address - Street 2:RM 441
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4099
Mailing Address - Country:US
Mailing Address - Phone:212-606-1964
Mailing Address - Fax:212-288-8260
Practice Address - Street 1:523 E 72ND ST
Practice Address - Street 2:RM 441
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-606-1964
Practice Address - Fax:212-288-8260
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007269363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant