Song, Jinsup

Song, Jinsup is an individual health care provider with primary practice located at 148 N 8Th St , Philadelphia PA 19107-2496. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Song, Jinsup can be contacted via phone (215) 777-5808.

Contact Information

Primary practice address
148 N 8Th St Philadelphia PA 19107-2496
Phone: (215) 777-5808
Fax: (215) 777-5825
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X SC004393L Pennsylvania
Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine 213EP1101X SC004393L Pennsylvania

Profile Details

NPI number 1295721777
LBN Legal business name Song, Jinsup
Credentials DPM PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Oct 3rd, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295721777 NPPES
Pennsylvania MEDICAID 0018076090003
Pennsylvania Other 8259607
Pennsylvania Other 893038
Pennsylvania Other 1125735
Pennsylvania Other 231365971
Pennsylvania MEDICAID 1807609
Pennsylvania Other P2665731
Pennsylvania Other 0499950000
Pennsylvania Other 231365971071
Pennsylvania Other S0819326
Pennsylvania Other 231365971
Pennsylvania Other 9231
Pennsylvania Other H19826
Pennsylvania Other 2353876
Pennsylvania Other 28824
Pennsylvania Other 480030054
Pennsylvania Other 3Y2326
Pennsylvania Other 435767

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