Provider Demographics
NPI:1396562641
Name:YOUNG, ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:YOUNG
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3152A KAIMUKI AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1452
Mailing Address - Country:US
Mailing Address - Phone:808-743-7643
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DRIVE
Practice Address - Street 2:#207
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3968
Practice Address - Country:US
Practice Address - Phone:808-674-0500
Practice Address - Fax:808-674-0511
Is Sole Proprietor?:No
Enumeration Date:2024-09-26
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT-5931225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist