Individual
MINA SONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-7772
Mailing address
210 MARTINE AVE, APT. 2A, WHITE PLAINS, NY 10601
(917) 379-1739
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
432854
NY
Other
Enumeration date
11/28/2023
Last updated
11/28/2023
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