Jae Keun Song

NPI 1447111612 · on the registry since 2025

Practice

Address: 7157 161st St Apt 2a
Fresh Meadows, NY 11365
Phone: (917) 832-2320
Organisation at this address: Gould Consulting And Staffing Agency Llc
Venus Consulting And Medical Staffing Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 2

Registry record

Primary taxonomy: 225100000X
225100000X
Licence states on file: NY
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2025-11-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York