Individual
DENISE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
300 COMMUNITY DR, MANHASSET, NY 11030-3816
(516) 562-2945
Mailing address
150 BERGEN ST # UH-I248, NEWARK, NJ 07103-2496
(973) 972-6056
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
303815
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2017
Last updated
08/27/2021
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