Provider Demographics
NPI:1861429656
Name:YOUNGS, GIA D (NP)
Entity type:Individual
Prefix:
First Name:GIA
Middle Name:D
Last Name:YOUNGS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 OSWEGO ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NY
Mailing Address - Zip Code:13316-1030
Mailing Address - Country:US
Mailing Address - Phone:315-245-1452
Mailing Address - Fax:
Practice Address - Street 1:600 SENECA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-2668
Practice Address - Country:US
Practice Address - Phone:315-363-1345
Practice Address - Fax:315-363-9243
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF333083363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02088140Medicaid
P15680Medicare UPIN
NYCC2589Medicare ID - Type Unspecified