Provider Demographics
NPI:1033230123
Name:YOUNG HUR M D P C
Entity Type:Organization
Organization Name:YOUNG HUR M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YOUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:HUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-735-8401
Mailing Address - Street 1:461 INDIAN WELLS AVE
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34759-3679
Mailing Address - Country:US
Mailing Address - Phone:732-735-8401
Mailing Address - Fax:
Practice Address - Street 1:461 INDIAN WELLS AVE
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34759-3679
Practice Address - Country:US
Practice Address - Phone:732-735-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA03066300207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ505755Medicare ID - Type Unspecified