Provider Demographics
NPI:1821592197
Name:YOUNG, ANDREW CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHRISTOPHER
Last Name:YOUNG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 WALNUT ST STE 420
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2197
Mailing Address - Country:US
Mailing Address - Phone:781-235-3444
Mailing Address - Fax:781-235-6888
Practice Address - Street 1:65 WALNUT ST STE 420
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-2197
Practice Address - Country:US
Practice Address - Phone:781-235-3444
Practice Address - Fax:781-235-6888
Is Sole Proprietor?:No
Enumeration Date:2018-03-21
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA286774207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine