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Individual

JI SUN SONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
900 FRANKLIN AVE, VALLEY STREAM, NY 11580-2145
(516) 256-6000
Mailing address
21763 77TH AVE, OAKLAND GARDENS, NY 11364-3024
(951) 333-1977

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
310880
NY

Other

Enumeration date
10/11/2022
Last updated
05/08/2024
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