Provider Demographics
NPI:1790755072
Name:YOUNGERMAN, JAY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:SCOTT
Last Name:YOUNGERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:875 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4942
Mailing Address - Country:US
Mailing Address - Phone:516-931-5552
Mailing Address - Fax:516-931-6563
Practice Address - Street 1:875 OLD COUNTRY RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4942
Practice Address - Country:US
Practice Address - Phone:516-931-5552
Practice Address - Fax:516-931-6563
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2010-01-05
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Provider Licenses
StateLicense IDTaxonomies
NY142777207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY91A741Medicare PIN
NYB20039Medicare UPIN