# VIBRANT LIFE MEDICINE, P.C.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1053729319
- **Authorized official:** DR. ERICA YOON-JUNG SONG MD (PRESIDENT)
- **Authorized official phone:** (201) 569-6190

## Contact information

- **Practice address:** 286 ENGLE ST, ENGLEWOOD, NJ 07631-2405
- **Practice address phone:** (201) 569-6190
- **Practice address fax:** (201) 569-6940
- **Mailing address:** 286 ENGLE ST, ENGLEWOOD, NJ 07631-2405
- **Mailing address phone:** (201) 569-6190
- **Mailing address fax:** (201) 569-6940

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 25MA07248000 | NJ | Yes |

## Other

- **Enumeration date:** 07/30/2014
- **Last updated:** 07/30/2014