Provider Demographics
NPI:1679941272
Name:YOUNG, KENYA (MS)
Entity type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 3RD AVE
Mailing Address - Street 2:APT 9A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-4793
Mailing Address - Country:US
Mailing Address - Phone:917-558-0375
Mailing Address - Fax:
Practice Address - Street 1:329 E 149TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5601
Practice Address - Country:US
Practice Address - Phone:718-769-2698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-13
Last Update Date:2015-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist