Individual provider Active NPI

Marianne Young, M.D.

  • Internal Medicine Physician
  • Syosset, NY
National Provider Identifier
1144329772
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
208596 Issued in NY
Practice address
175 Jericho Tpke
Suite 204
Syosset, NY 11791-4532
Phone
(631) 249-2242
NPI assigned
Sep 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 208596 NY Primary

Addresses

Primary practice location

175 Jericho Tpke
Suite 204
Syosset, NY 11791-4532

Mailing address

172 Harrison Ave
Mineola, NY 11501-3968
Phone (516) 248-3685

Other identifiers 1

IdentifierTypeStateIssuer
02162196MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000310 NY Practitioner - Internal Medicine 2769429760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
208596NYMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144329772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 HARRISON AVE",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013968",
            "telephone_number": "516-248-3685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 JERICHO TPKE",
            "address_2": "SUITE 204",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914532",
            "telephone_number": "631-249-2242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MARIANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "208596",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02162196",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syosset, NY

Sources for this page

Verify at the official NPI Registry.