Provider Demographics
NPI:1699188078
Name:YOUNG, ANDREA J (NP-C)
Entity type:Individual
Prefix:MISS
First Name:ANDREA
Middle Name:J
Last Name:YOUNG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3125 US ROUTE 9W
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:NY
Mailing Address - Zip Code:12553-6763
Mailing Address - Country:US
Mailing Address - Phone:914-502-3998
Mailing Address - Fax:518-708-6889
Practice Address - Street 1:6 PARK AVE
Practice Address - Street 2:
Practice Address - City:VALLEY COTTAGE
Practice Address - State:NY
Practice Address - Zip Code:10989-1812
Practice Address - Country:US
Practice Address - Phone:561-635-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY404100163WP0807X, 363LP0808X
NY341820363LF0000X
FLARNP 9196852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily