Provider Demographics
NPI:1144437039
Name:CENTER FOR HEALTH AND DIABETES, PLLC
Entity type:Organization
Organization Name:CENTER FOR HEALTH AND DIABETES, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:E
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RN,MS,FNP-C,CDE
Authorized Official - Phone:757-923-0300
Mailing Address - Street 1:210 CHENANGO CRES
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-9257
Mailing Address - Country:US
Mailing Address - Phone:757-923-4631
Mailing Address - Fax:
Practice Address - Street 1:131 N SARATOGA ST
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-5258
Practice Address - Country:US
Practice Address - Phone:747-923-0300
Practice Address - Fax:757-923-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024165293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty