| Susan N Young Inc | |
|
13400 Sutton Park Dr S Suite 1504 Jacksonville FL 32224-0236 | |
| (904) 223-6414 | |
| (904) 223-6418 |
| Full Name | Susan N Young Inc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 13400 Sutton Park Dr S, Jacksonville, Florida |
| Authorized Official Name and Position | Susan N Young (OWNER) |
| Authorized Official Contact | 9042236414 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan N Young Inc 13400 Sutton Park Dr S Suite 1504 Jacksonville FL 32224-0236 Ph: (904) 223-6414 | Susan N Young Inc 13400 Sutton Park Dr S Suite 1504 Jacksonville FL 32224-0236 Ph: (904) 223-6414 |
| NPI Number | 1770788390 |
|---|---|
| Provider Enumeration Date | 06/15/2007 |
| Last Update Date | 10/17/2011 |
| Medicare PECOS PAC ID | 9537256722 |
|---|---|
| Medicare Enrollment ID | O20071106000251 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770788390 | NPI | - | NPPES |
| AF756 | Other | FL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PY7306 (Florida) | Primary |
| Provider Name | Susan N Young |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215039656 PECOS PAC ID: 6406951086 Enrollment ID: I20070411000113 |
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