Active NPI
Mary Elizabeth Young, PT
- Physical Therapist
- Monroe, NY
National Provider Identifier
1255905055
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9080
- Practice address
- 745 State Route 17M Ste 104
Monroe, NY 10950-2663 - Phone
- (845) 782-3200
- Fax
- (845) 782-3100
- NPI assigned
- May 17, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9080 | NY | Primary |
Addresses
Primary practice location
745 State Route 17M Ste 104
Monroe, NY 10950-2663
Mailing address
16 Maybrook Rd Ste L
Campbell Hall, NY 10916-2741
Phone (845) 636-4344
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9080 | NY | MD | Physical Therapist |
| 009080 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1621209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621209600000",
"number": "1255905055",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MAYBROOK RD STE L",
"city": "CAMPBELL HALL",
"state": "NY",
"postal_code": "109162741",
"telephone_number": "845-636-4344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "745 STATE ROUTE 17M STE 104",
"city": "MONROE",
"state": "NY",
"postal_code": "109502663",
"telephone_number": "845-782-3200",
"fax_number": "845-782-3100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-17",
"last_updated": "2021-05-17",
"certification_date": "2021-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "9080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.