Basic Information
| Provider Information | |||||||||
| NPI: | 1629279294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | YOUNG HONG | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | OTR-L | ||||||||
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| Mailing Information | |||||||||
| Address1: | 86 E HOWARD ST | ||||||||
| Address2: | UNIT #202 | ||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021698727 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6173889541 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2049 DORCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | DORCHESTER CENTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021244742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6178253905 | ||||||||
| FaxNumber: | 6178251951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225XN1300X | OT-5895 | MA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation |
No ID Information.