Sae Ryoung Song, M.D., P.a.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

ME0029968 Issued in FL

Legal business name

SAE RYOUNG SONG, M.D., P.A.

Practice address

6245 State Road 54
New Port Richey, FL 34653-6006

Phone

(727) 846-9496

Fax

(727) 849-8410

NPI assigned

Mar 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sae R Song, M.D.

Title

Psychiatrist/Owner

Phone

(727) 846-9496

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1659646354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6245 STATE ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346536006",
            "telephone_number": "727-846-9496",
            "fax_number": "727-849-8410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6245 STATE ROAD 54",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346536006",
            "telephone_number": "727-846-9496",
            "fax_number": "727-849-8410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAE RYOUNG SONG, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "SAE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PSYCHIATRIST/OWNER",
        "authorized_official_telephone_number": "727-846-9496",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME0029968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045480000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in New Port Richey, FL
• Providers in New Port Richey, FL by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.