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Individual

DR. JAE WOOK SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
33 W 42ND ST, NEW YORK, NY 10036-8005
(212) 938-5836
(212) 938-4065
Mailing address
10 RIVER RD APT 11E, NEW YORK, NY 10044-1148
(803) 840-8028
(212) 938-4065

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV007050
NY

Other

Enumeration date
08/18/2006
Last updated
07/08/2007
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