Individual
VINCENT K YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5401 OLD YORK RD, KLEIN 205, PHILADELPHIA, PA 19141-3030
(215) 456-7150
(215) 456-2379
Mailing address
PO BOX 8500-8735, PHILADELPHIA, PA 19178-8735
(215) 456-7000
(215) 254-2599
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD035544E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001093158
—
PA
01
—
402352
BLUE SHIELD
PA
Enumeration date
04/20/2006
Last updated
08/01/2012
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