Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | OT-5895 | MA |
NPI | 1629279294 |
---|---|
Provider Name | Mr. David Young Hong |
First Address | Quincy, MA 02169-8727 |
Second Address | Dorchester Center, MA 02124-4742 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2007 |
Last Update Date | 08/07/2007 |