Individual
MARY C YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1000 ASYLUM AVE STE 2109A, NEONATAL INTENSIVE CARE, HARTFORD, CT 06105-1719
(860) 714-6581
Mailing address
114 WOODLAND STREET, NEONATAL INTENSIVE CARE, HARTFORD, CT 06105
(860) 714-4404
(860) 714-8218
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
000953
CT
363LP0200X
Pediatric Nurse Practitioner
Primary
000953
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004254265
—
CT
Enumeration date
02/22/2006
Last updated
02/13/2023
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