Individual
DR. SONG KI YU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1817 BLACK ROCK TPKE, STE 8 ADVANCED MEDICAL FOOTCARE, FAIRFIELD, CT 06825-3546
(203) 330-8080
(203) 334-6924
Mailing address
1817 BLACK ROCK TPKE, STE 8, FAIRFIELD, CT 06825-3546
(203) 330-8080
(203) 334-6924
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000764
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5454010001
DME
CT
Enumeration date
09/20/2005
Last updated
03/04/2014
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