Provider Demographics
NPI:1548321375
Name:YOUNG, BRUCE K (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:K
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:SUITE 5G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-6359
Mailing Address - Fax:212-263-6329
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SUITE 5G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-6359
Practice Address - Fax:212-263-6329
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY094388207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY655071Medicare ID - Type UnspecifiedPROVIDER NUMBER
NYB78697Medicare UPIN