Individual
FREDERICK YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 CENTERTON RD, MOUNT LAUREL, NJ 08054-6103
(856) 359-3654
(856) 359-3680
Mailing address
100 CENTERTON RD, MOUNT LAUREL, NJ 08054-6103
(856) 359-3654
(856) 359-3680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00554300
NJ
152W00000X
Optometrist
OEG001612
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7916604
—
NJ
Enumeration date
06/22/2005
Last updated
08/23/2010
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