Provider Demographics
NPI:1841264330
Name:YOUNG, SHUG-HONG (MD)
Entity type:Individual
Prefix:
First Name:SHUG-HONG
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BELLE MEAD ROAD
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-9999
Mailing Address - Country:US
Mailing Address - Phone:631-642-1500
Mailing Address - Fax:
Practice Address - Street 1:210 N BELLE MEAD RD
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3522
Practice Address - Country:US
Practice Address - Phone:631-642-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-14
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143130207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY767226Medicaid
NY88A95WS575Medicare PIN
NY88A95Medicare ID - Type Unspecified
NYB87344Medicare UPIN