Provider Demographics
NPI:1871277681
Name:YOUNG, MELISSA (OD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:YOUNG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 US ROUTE 1
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-7023
Mailing Address - Country:US
Mailing Address - Phone:207-729-8474
Mailing Address - Fax:
Practice Address - Street 1:407 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-7023
Practice Address - Country:US
Practice Address - Phone:207-729-8474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT1068152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist