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NPI Code Detail

MEDICARE: SARAH SONG

MEDICARE: SARAH SONG
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker

General Provider Information

NPI Number : 1770907081
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH SONG
Provider Business Mailing Address
First Line : 590 AVENUE OF AMERICAS
Second Line :
City : NEW YORK
State : NY
Zip : 10011-9904
Country : US
Telephone Number : 212-633-9300
Fax Number :
Provider Business Practice Location Address
First Line : 109 E 115TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10029-1186
Country : US
Telephone Number : 212-633-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2014
Last Update Date : 01/06/2020

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Directions to “ SARAH SONG ” Practice Location

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