Provider Demographics
NPI:1154341246
Name:YOUNGELMAN, DAVID R (PSYD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:YOUNGELMAN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5211 VERMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8129
Mailing Address - Country:US
Mailing Address - Phone:484-368-9275
Mailing Address - Fax:570-402-1144
Practice Address - Street 1:35 E ELIZABETH AVE STE 113
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6502
Practice Address - Country:US
Practice Address - Phone:484-368-9275
Practice Address - Fax:570-402-1144
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSI02660103TC0700X
PAPS015742103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA162529Medicare UPIN