Individual
DIANA YOUNGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANPC
Contact information
Practice address
1500 ROUTE 112 BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 751-3000
(631) 509-6654
Mailing address
1500 ROUTE 112 BLDG 4, PORT JEFFERSON STATION, NY 11776-8055
(631) 751-3000
(631) 509-6559
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F370030
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02597895
—
NY
Enumeration date
06/23/2005
Last updated
08/11/2021
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