Provider Demographics
NPI:1841468816
Name:ANN YOUNG MEDICAL P.C
Entity type:Organization
Organization Name:ANN YOUNG MEDICAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:X
Authorized Official - Last Name:LI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-568-9538
Mailing Address - Street 1:133-36 41 ROAD
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3666
Mailing Address - Country:US
Mailing Address - Phone:718-568-9538
Mailing Address - Fax:718-961-1393
Practice Address - Street 1:13336 41ST RD
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3666
Practice Address - Country:US
Practice Address - Phone:718-568-9538
Practice Address - Fax:718-961-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY244809261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1053325407Medicare PIN