Individual
MR. KI IN SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
62 COTTAGE ST, JERSEY CITY, NJ 07306
(201) 653-0555
(201) 653-7683
Mailing address
62 COTTAGE ST, JERSEY CITY, NJ 07306
(201) 653-0555
(201) 653-7683
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
26880
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2924102
—
NJ
Enumeration date
01/11/2007
Last updated
07/08/2007
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