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General NPI Number Information
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NPI Number | 1285077123
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Entity Type | Organization
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Legal Business Name | SUNNY FRIENDLY MEDICAL PC
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 4199 MAIN ST STE 201
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City | FLUSHING
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State | NY
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Zip | 11355-3821
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Country | US
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Telephone | 718-961-1897
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Fax |
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Provider Business Mailing Address
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Address Line | 4199 MAIN ST STE 201
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City | FLUSHING
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State | NY
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Zip | 11355-5164
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Country | US
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Telephone | 718-961-1897
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Fax | 718-766-9749
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Authorized Official
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Title or Position | OWNER
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Name | XIAOYAN SONG
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Credential |
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Telephone | 646-400-3589
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 267041
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License Number State | NY
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