Organization
ISLAND PHYSIATRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM SONG MD (PRESIDENT)
(631) 425-1980
Entity
Organization
Contact information
Practice address
700 PATCHOGUE YAPHANK RD STE 32, MEDFORD, NY 11763-2235
(631) 425-1980
Mailing address
PO BOX 1487, MELVILLE, NY 11747-0287
(631) 425-1980
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
208578
NY
Other
Enumeration date
06/01/2007
Last updated
08/22/2020
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