GI SUK SONG (NPI# 1114952066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114952066 |
| Entity Type | Individual |
| Full Name | GI SUK SONG |
| Credential | MD |
| Practice Address |
105 Marys Ave Kingston NY 12401 |
| Mailing Address |
Po Box 2270 Kingston NY 12402-2270 |
| Practice Telephone | 8453382500 |
| Practice Fax Number | 8453385616 |
| Mailing Telephone | 8453397582 |
| Mailing Fax Number | 8453365616 |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2018-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
170312-1 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 01232508 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 396 Broadway, Kingston, NY 124014626 | 8453313131 | |
| 42084 State Highway 28, Margaretville, NY 124552820 | 8455862631 |
| Street Address |
105 MARYS AVE |
| City | KINGSTON |
| State | NY |
| Zip Code | 12401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598768582 | Susan Ruth Hollar | Audiologist | 105 Marys Ave, Department of Audiology, Kingston, NY 12401-5848 | 2005-05-23 |
| 1699337816 | Rachel Lee Bugarin | Nurse Practitioner | 105 Marys Ave, Kingston, NY 12401-5848 | 2019-07-08 |
| 1417443433 | Tara Laine Mainieri | Nurse Practitioner | 105 Marys Ave, Kingston, NY 12401-5848 | 2018-07-02 |
| 1508387655 | Stephen Edward Dunham Sr. | Podiatrist | 105 Marys Ave, Kingston, NY 12401-5848 | 2017-06-29 |
| 1972037224 | Tammy Carlile | Social Worker | 105 Marys Ave, Kingston, NY 12401-5848 | 2017-04-13 |
| 1700164258 | Specialty Fittings, Incorporated | Prosthetic/Orthotic Supplier | 105 Marys Ave, Kingston, NY 12401-5848 | 2011-08-02 |
| 1013200161 | Manpreet Grewal | Psychiatry & Neurology | 105 Marys Ave, Kingston, NY 12401-5848 | 2011-05-24 |
| 1215256250 | Jennifer Mary Spada | Counselor | 105 Marys Ave, Kingston, NY 12401-5848 | 2010-05-28 |
| 1457680142 | Subooha Zafar, Md LLC | Internal Medicine | 105 Marys Ave, Benedictine Hospital Sleep Lab, Kingston, NY 12401-5848 | 2009-12-09 |
| 1518170356 | Stefania Stella Giobbe | Pathology | 105 Marys Ave, Kingston, NY 12401-5848 | 2007-05-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215565783 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue--breast Depart., Kingston, NY 12401 | 2020-03-31 |
| 1306474879 | Health Quest Medical Practice, PC | Surgery | 1240 Ulster Avenue --surg. Onc. Dept, Kingston, NY 12401 | 2020-03-31 |
| 1811523384 | Health Quest Medcial Practice, PC | Podiatrist | The Center for Wound Healing, 670 Stoneleigh Avenue, Carmel, NY 12401 | 2020-03-17 |
| 1013552181 | Health Quest Medical Practice, PC | Emergency Medicine | 1240 Ulster Avenue, Kingston, NY 12401 | 2019-11-13 |
| 1073156808 | Vala Conklin | Hearing Instrument Specialist | Beltone, 10 Westbrook Lane, Kingston, NY 12401 | 2019-10-24 |
| 1306304860 | Laura Juliane Isele | Dietitian, Registered | 521 Boices Lane Taconic Ddso, Kingston, NY 12401 | 2019-03-04 |
| 1104345107 | Shiv Ramlochan | Licensed Practical Nurse | 1 Family Drive, Kingston, NY 12401 | 2017-09-12 |
| 1346776333 | Sara Bockelmann | Licensed Practical Nurse | 616 Kiersted Ave, Kingston, NY 12401 | 2017-05-11 |
| 1093265472 | Janelle Haylett | Pathology | 121 Rondout Drive, Q, Kingston, NY 12401 | 2016-10-10 |
| 1669830873 | Julie Brady | Counselor | 154 Fair Street #2, Kingston, NY 12401 | 2016-02-02 |
| Find all providers in zip 12401 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487609483 | Vision Imaging of Kingston LLC | Radiology | 517 Pierce Street, Kingston, PA 18704-5756 | 2006-05-24 |
| 1154384766 | Steven Daniel Schwartz | Radiology | 45 Pine Grove Ave, Kingston, NY 12401 | 2006-04-07 |
| 1558906610 | Health Quest Medical Practice, PC | Radiology | 1240 Ulster Avenue, Kingston, NY 12401 | 2019-11-13 |
| 1861733701 | St Peters Health Partners Medical Associates, PC | Radiology | 45 Pine Grove Ave, Kingston, NY 12401-5407 | 2013-03-01 |
| 1821225368 | Timothy Madden | Radiology | 45 Pine Grove Ave, Kingston, NY 12401-5407 | 2009-06-11 |
| 1255475133 | Jaime L Parent | Radiology | 45 Pine Grove Ave, Kingston, NY 12401 | 2007-02-16 |
| 1336170612 | David J Hall | Radiology | 45 Pine Grove Ave, Kingston, NY 12401-5407 | 2006-07-05 |
| 1437180619 | Thomas A Koshy | Radiology | 45 Pine Grove Ave, Kingston, NY 12401-5407 | 2006-07-05 |
| 1740211374 | Orin A Rossett | Radiology | 105 Marys Ave, Kingston, NY 12401-5848 | 2006-07-05 |
| 1902837198 | Bruce B Moor | Radiology | 45 Pine Grove Ave, Kingston, NY 12401-5407 | 2006-07-05 |
| Find all providers in KINGSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.