Provider Demographics
NPI:1013752047
Name:YOUNG, LONDON
Entity type:Individual
Prefix:
First Name:LONDON
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 WARRENSVILLE HEIGHTS
Mailing Address - Street 2:#201253
Mailing Address - City:SHAKER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44122-2728
Mailing Address - Country:US
Mailing Address - Phone:216-206-8121
Mailing Address - Fax:
Practice Address - Street 1:3675 WARRENSVILLE HEIGHTS
Practice Address - Street 2:#201253
Practice Address - City:SHAKER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44120
Practice Address - Country:US
Practice Address - Phone:216-206-8121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies