Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 208685 | MA |
NPI | 1043229768 |
---|---|
Provider Name | Peter C. Young |
First Address | Quincy, MA 02169-4339 |
Second Address | Quincy, MA 02169-4339 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 05/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0027527 | NEIGHBORHOOD HEALTH PLAN (01) | MA |
0185621 | (05) | MA |
208685 | TUFTS HEALTH PLAN (01) | MA |
2403883-003 | CIGNA (01) | MA |
400968 | HARVARD PILGRIM (01) | MA |
H26376 | (02) | MA |
J23050 | BLUE CROSS (01) | MA |
P00278138 | MEDICARE RAILROAD (01) | MA |