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General NPI Number Information
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NPI Number | 1427822196
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Entity Type | Organization
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Legal Business Name | ALLWELL HEALTH MEDICAL PC
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Dates
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Enumeration Date | 11/13/2023
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 4161 KISSENA BLVD STE C
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City | FLUSHING
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State | NY
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Zip | 11355-3105
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Country | US
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Telephone | 718-878-6920
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Fax | 718-878-6920
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Provider Business Mailing Address
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Address Line | PO BOX 604675
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City | BAYSIDE
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State | NY
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Zip | 11360-4675
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Country | US
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Telephone | 718-878-6920
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Fax | 718-878-6920
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Authorized Official
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Title or Position | MD
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Name | DR. SHUHUA SONG
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Credential | MD
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Telephone | 718-878-6920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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