Provider Demographics
NPI:1629279294
Name:YOUNG HONG, DAVID (OTR-L)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:YOUNG HONG
Suffix:
Gender:M
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 E HOWARD ST
Mailing Address - Street 2:UNIT #202
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-8727
Mailing Address - Country:US
Mailing Address - Phone:617-388-9541
Mailing Address - Fax:
Practice Address - Street 1:2049 DORCHESTER AVE
Practice Address - Street 2:
Practice Address - City:DORCHESTER CENTER
Practice Address - State:MA
Practice Address - Zip Code:02124-4742
Practice Address - Country:US
Practice Address - Phone:617-825-3905
Practice Address - Fax:617-825-1951
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAOT-5895225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation