Provider Demographics
NPI:1811318579
Name:GEORGE PH YOUNG MD FACS PC
Entity type:Organization
Organization Name:GEORGE PH YOUNG MD FACS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PH
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-876-9811
Mailing Address - Street 1:1060 5TH AVE
Mailing Address - Street 2:SUITE 1E/F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-0104
Mailing Address - Country:US
Mailing Address - Phone:212-876-9811
Mailing Address - Fax:212-876-9806
Practice Address - Street 1:1060 5TH AVE
Practice Address - Street 2:SUITE 1E/F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-0104
Practice Address - Country:US
Practice Address - Phone:212-876-9811
Practice Address - Fax:212-876-9806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-26
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty