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Organization
INNOCARE MEDICAL PC
Active
Organization
INNOCARE MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JIN SONG MD (CEO)
(718) 213-6214
Entity
Organization
Contact information
Practice address
4160 MAIN ST STE 203, FLUSHING, NY 11355-3899
(718) 290-5810
Mailing address
14109 28TH AVE APT 2B, FLUSHING, NY 11354-1601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/27/2019
Last updated
03/11/2020
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