# ISLAND PHYSIATRY, PC

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

## Provider details

- **NPI number:** 1619179744
- **Authorized official:** DR. SAM SONG MD (PRESIDENT)
- **Authorized official phone:** (631) 425-1980

## Contact information

- **Practice address:** 700 PATCHOGUE YAPHANK RD STE 32, MEDFORD, NY 11763-2235
- **Practice address phone:** (631) 425-1980
- **Mailing address:** PO BOX 1487, MELVILLE, NY 11747-0287
- **Mailing address phone:** (631) 425-1980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 208578 | NY | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 08/22/2020