Individual
YOUNG SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPED
Contact information
Practice address
14431 41ST AVE STE L6, FLUSHING, NY 11355-1452
(718) 359-3348
(718) 359-0388
Mailing address
14431 41ST AVE STE L6, FLUSHING, NY 11355-1452
(718) 359-3348
(718) 359-0388
Taxonomy
Speciality
Code
Description
License number
State
224L00000X
Pedorthist
Primary
CPED3468
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02620120
—
NY
Enumeration date
03/16/2017
Last updated
03/16/2017
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