Provider Demographics
NPI:1740479971
Name:YOUNG, JENNIFER LEE (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEE
Last Name:YOUNG
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Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 17334
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-1334
Mailing Address - Country:US
Mailing Address - Phone:703-443-6717
Mailing Address - Fax:703-443-8643
Practice Address - Street 1:19415 DEERFIELD AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8452
Practice Address - Country:US
Practice Address - Phone:703-724-1195
Practice Address - Fax:703-724-4495
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2014-02-21
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Provider Licenses
StateLicense IDTaxonomies
VA0101249090208800000X
CAA95088208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology