- Practice location
- 501 Iron Bridge RD, Suite 9, Freehold, NJ 07728-5304
- Phone
- 866-514-0025
- Fax
- 732-358-0524
- Last updated
- November 25, 2014
The Youth Fountain is a healthcare organization based in Freehold, NJ. The Youth Fountain practices in Freehold, NJ. The NPI Number for The Youth Fountain is 1598190506. The current practice location address for The Youth Fountain is 501 Iron Bridge RD, Suite 9, Freehold, NJ 07728-5304 and can be reached out via phone at 866-514-0025 and via fax at 732-358-0524.
Provider Profile Details
- NPI Number
- 1598190506
- Provider Name
- The Youth Fountain
- Provider Entity Type
- Organization
- Address
- 501 Iron Bridge RD, Suite 9, Freehold, NJ 07728-5304
- Phone Number
- 866-514-0025
- Fax Number
- 732-358-0524
- Primary Taxonomy
- Surgery · 208600000X
- Organization Subpart
- No
- Authorized Official
- Dr. Emil Shakov, MD · Owner · 866-514-0025
- Other Names
- Youth Fountain (Doing Business As)
- Provider Enumeration Date
- September 9, 2013
- Last Update Date
- November 25, 2014
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 501 Iron Bridge RD
Suite 9
Freehold, NJ 07728-5304 - City
- Freehold
- State
- New Jersey
- Zip
- 07728-5304
- Phone Number
- 866-514-0025
- Fax Number
- 732-358-0524
Provider Business Mailing Address Details
- Address
- 501 Iron Bridge RD
Suite 9
Freehold, NJ 07728-5304 - City
- Freehold
- State
- NJ
- Zip
- 07728-5304
- Phone Number
- 866-514-0025
- Fax Number
- 732-358-0524
License Information
- Taxonomy
- Surgery · 208600000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of The Youth Fountain?
The NPI number of The Youth Fountain is 1598190506. It was assigned on September 9, 2013 and is currently active in the NPPES registry.
What is the specialty of The Youth Fountain?
The Youth Fountain is registered under the primary taxonomy Surgery (code 208600000X).
Where does The Youth Fountain practice?
The practice location is 501 Iron Bridge RD, Suite 9, Freehold, NJ 07728-5304. The office can be reached at 866-514-0025 (phone) or 732-358-0524 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1598190506 directly on the NPPES registry website.