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General NPI Number Information
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NPI Number | 1629279294
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Entity Type | Individual
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Provider Name | DAVID YOUNG HONG OTR-L
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Gender | Male
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2049 DORCHESTER AVE
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City | DORCHESTER CENTER
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State | MA
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Zip | 02124-4742
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Country | US
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Telephone | 617-825-3905
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Fax | 617-825-1951
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Provider Business Mailing Address
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Address Line | 86 E HOWARD ST UNIT #202
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City | QUINCY
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State | MA
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Zip | 02169-8727
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Country | US
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Telephone | 617-388-9541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | OT-5895
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License Number State | MA
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