Provider Demographics
NPI:1033451505
Name:YOUNG, JOSEPH A JR (LAC)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:A
Last Name:YOUNG
Suffix:JR
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 1/2 ALLEN ST
Mailing Address - Street 2:3C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-5314
Mailing Address - Country:US
Mailing Address - Phone:917-929-1058
Mailing Address - Fax:
Practice Address - Street 1:67 IRVING PL
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-2202
Practice Address - Country:US
Practice Address - Phone:917-929-1058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004998171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist