Provider Demographics
NPI:1720174717
Name:YOUNG, IVEN SHELDON (MD)
Entity type:Individual
Prefix:MR
First Name:IVEN
Middle Name:SHELDON
Last Name:YOUNG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SEVENTH AVENUE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10001
Mailing Address - Country:US
Mailing Address - Phone:212-675-9332
Mailing Address - Fax:212-604-3844
Practice Address - Street 1:275 SEVENTH AVENUE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-356-4474
Practice Address - Fax:212-356-4608
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2014-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084132207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00126256Medicaid
C06580Medicare UPIN
NY00126256Medicaid