Basic Information
| Provider Information | |||||||||
| NPI: | 1194817627 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | YOUNG | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 829641 | ||||||||
| Address2: | |||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191820001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2673705295 | ||||||||
| FaxNumber: | 2152303725 | ||||||||
| Practice Location | |||||||||
| Address1: | 595 W STATE ST | ||||||||
| Address2: | |||||||||
| City: | DOYLESTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 189012554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2153450105 | ||||||||
| FaxNumber: | 2153450562 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2006 | ||||||||
| LastUpdateDate: | 05/01/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | OS005905L | PA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 1194817627 | 01 | PA | GHP | OTHER | 0011621840007 | 05 | PA | MEDICAID | 25-1645055 | 01 | PA | CIGNA-GREAT WEST HEALTHCARE | OTHER | 25-1645055 | 01 | PA | COVENTRY/HEALTH AMERICA | OTHER | P011117493 | 01 | PA | RR MEDICARE | OTHER | 0011621840006 | 05 | PA | MEDICAID | 50110611 | 01 | PA | CAPITAL BLUE CROSS | OTHER | 829910 | 01 | PA | FPH | OTHER | 4113114 | 01 | PA | AETNA | OTHER |