# SONG PHYSICAL MEDICINE, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053358424
- **Authorized official:** DR. SANG HO SONG D.O. (OWNER)
- **Authorized official phone:** (732) 991-6882

## Contact information

- **Practice address:** 15 S MAIN ST, EDISON, NJ 08837-3447
- **Practice address phone:** (732) 991-6882
- **Practice address fax:** (732) 906-0124
- **Mailing address:** PO BOX 1241, EDISON, NJ 08818-1241
- **Mailing address phone:** (732) 991-6882
- **Mailing address fax:** (732) 906-0124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | 25MB07701500 | NJ | Yes |

## Other

- **Enumeration date:** 06/02/2006
- **Last updated:** 08/22/2020