Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 296135 | NY |
Y | 207XS0106X | Orthopaedic Hand Surgeon | 296135 | NY |
N | 207XS0106X | Orthopaedic Hand Surgeon | 37884 | SC |
NPI | 1144463597 |
---|---|
Provider Name | Mae Ewing Young |
First Address | Middletown, NY 10941-4028 |
Second Address | Middletown, NY 10941-7001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2009 |
Last Update Date | 19/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
378843 | (05) | SC |