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General NPI Number Information
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NPI Number | 1972842144
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Entity Type | Individual
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Provider Name | MR. THOMAS YUNG
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Gender | Male
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Dates
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Enumeration Date | 02/08/2013
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Last Update Date | 08/06/2014
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Provider Practice Location Address
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Address Line | 3800 RESERVOIR ROAD, NW LL BLES BUILDING
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City | WASHINGTON
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State | DC
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Zip | 20007
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Country | US
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Telephone | 202-444-2053
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Fax | 202-444-0067
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Provider Business Mailing Address
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Address Line | 3800 RESERVOIR ROAD, NW LOWER LEVEL BLES BUILDING
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City | WASHINGTON
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State | DC
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Zip | 20007
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Country | US
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Telephone | 917-572-0994
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R200273
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | RN1026533
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License Number State | DC
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