Provider Demographics
NPI:1437156924
Name:YOUNG, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 PLEASANT ST, SUITE 2
Mailing Address - Street 2:CONCORD OTOLARYNGOLOGY
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-2915
Mailing Address - Country:US
Mailing Address - Phone:603-224-2353
Mailing Address - Fax:603-224-6874
Practice Address - Street 1:194 PLEASANT ST, SUITE 2
Practice Address - Street 2:CONCORD OTOLARYNGOLOGY
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-2915
Practice Address - Country:US
Practice Address - Phone:603-224-2353
Practice Address - Fax:603-224-6874
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2011-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHA75231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH40000387Medicaid
NHNH2213OtherHPHC
NH0058799OtherTUFTS
NH7305240Y0NH01OtherBC
NH40000387Medicaid