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General NPI Number Information
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NPI Number | 1275558868
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Entity Type | Organization
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Legal Business Name | S & SONG INC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4616 MORNING RIDE CT
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City | ELLICOTT CITY
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State | MD
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Zip | 21042
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Country | US
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Telephone | 410-829-5148
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Fax | 410-462-3517
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Provider Business Mailing Address
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Address Line | 4616 MORNING RIDE CT
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City | ELLICOTT CITY
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State | MD
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Zip | 21042
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Country | US
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Telephone | 410-461-4425
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Fax | 410-462-3517
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SOONOK KONG SONG
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Credential | CNS-PMM
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Telephone | 410-829-5148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364S00000X
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Taxonomy Name | Clinical Nurse Specialist
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License Number | R057717
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License Number State | MD
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