Basic Information
| Provider Information | |||||||||
| NPI: | 1538259288 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNG | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | LOUISE | ||||||||
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| Credential: | FNP, DNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 PARK STREET | ||||||||
| Address2: | GLENS FALLS HOSPITAL - CREDENTIALING | ||||||||
| City: | GLENS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 128014413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5189265924 | ||||||||
| FaxNumber: | 5189266983 | ||||||||
| Practice Location | |||||||||
| Address1: | 79 NORTH STREET | ||||||||
| Address2: | GRANVILLE MEDICAL CENTER | ||||||||
| City: | GRANVILLE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5186420612 | ||||||||
| FaxNumber: | 5186420693 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 03/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | F320012-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | F320012 | 01 | NY | LICENSE | OTHER |