DR. BOYOUNG SONG (NPI# 1528296886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528296886 |
| Entity Type | Individual |
| Full Name | DR. BOYOUNG SONG |
| Credential | M.D. |
| Practice Address |
1000 East Mountain Blvd. Wilkes-barre PA 18711-3622 |
| Mailing Address |
100 N Academy Ave Danville PA 17822-4903 |
| Practice Telephone | 5708086000 |
| Practice Fax Number | 5708086061 |
| Mailing Telephone | 5702716144 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2020-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD456961 | PA | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MT205629 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
1000 EAST MOUNTAIN BLVD. |
| City | WILKES-BARRE |
| State | PA |
| Zip Code | 18711-3622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427050723 | Thomas Andrew Erchinger | Surgery | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3762 | 2005-06-01 |
| 1679007033 | Tyler Anderson | Nurse Anesthetist, Certified Registered | 1000 East Mountain Blvd., Wilkes-barre, PA 18711 | 2017-04-12 |
| 1033661061 | Stanley J Yanik | Internal Medicine | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3610 | 2016-10-25 |
| 1881143709 | Stephanie Dosiak | Physician Assistant | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3732 | 2016-10-04 |
| 1649675240 | Ryan Reddick | Anesthesiology | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3475 | 2014-10-27 |
| 1114327988 | Jignesh Patel | Hospitalist | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3539 | 2014-08-29 |
| 1063831808 | Afghani Roshan | Emergency Medicine | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3420 | 2014-04-09 |
| 1427484187 | Alisha R Wainwright | Physician Assistant | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3610 | 2013-09-25 |
| 1669804175 | Hasan Mohamed Zerti | Internal Medicine | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3539 | 2013-08-07 |
| 1942644828 | Luke Edward Sullivan | Emergency Medicine | 1000 East Mountain Blvd., Wilkes-barre, PA 18711-3420 | 2013-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467924274 | Leeann Kayal | Nurse Practitioner | 111 East End Boulevard, Wilkes Barre, PA 18711 | 2018-12-19 |
| 1336661701 | Patricia Dworak | Occupational Therapist | 1175 East Mountain Boulevard, Wilkes-barre, PA 18711 | 2017-07-07 |
| 1992160352 | Hope Danishanko | Social Worker | 111 East End Blvd, Wilkes Barre, PA 18711 | 2015-12-29 |
| 1477962785 | Jennifer L. Heck | Physical Therapist | 1140 Route 315, Suite 207, Wilkes-barre, PA 18711 | 2014-08-12 |
| 1821338807 | Melinda Flaim | Physical Therapist | 1555 East End Blvd, Wilkes Barre, PA 18711 | 2013-02-27 |
| 1598900953 | Elizabeth Patricia Keating | Pharmacist | 1000 East Mountain Drive, Wilkes Barre, PA 18711 | 2008-12-12 |
| 1457433294 | Christopher William O'brien | Specialist/Technologist | King's College, 133 North River Street, Wilkes-barre, PA 18711 | 2006-10-20 |
| 1821197450 | Louis Jay Freedman | Obstetrics & Gynecology | Valley Medical Building, 3rd Floor, 1010 East Mountain Boulevard, Wilkes-barre, PA 18711 | 2006-09-21 |
| 1730282625 | Natalia N Belikova | Internal Medicine | 1111 East End Boulvard, Wilkesbarre, PA 18711 | 2006-09-06 |
| 1609883628 | Va Medical Center | General Acute Care Hospital | 1111 East End Blvd., Wilkes-barre, PA 18711 | 2006-08-02 |
| Find all providers in zip 18711 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720630650 | Broad Street Professional Medical Services LLC | Surgery | 2033 S Broad St Ste A, Philadelphia, PA 19148-5505 | 2019-07-11 |
| 1124670922 | Broad Street Medical LLC | Surgery | 2033 S Broad St Ste B, Philadelphia, PA 19148-5505 | 2019-07-11 |
| 1932610755 | Vascular Surgical Specialists Pllc | Surgery | 1450 E Boot Rd Ste 600b, West Chester, PA 19380-5968 | 2017-10-19 |
| 1336515956 | Aria Health Physician Services | Surgery | 9501 Roosevelt Blvd Ste 312, Philadelphia, PA 19114-1028 | 2015-08-18 |
| 1437525490 | Advanced Vein and Laser Center Lancaster, LLC | Surgery | 896a Plaza Blvd, Lancaster, PA 17601-2745 | 2015-08-13 |
| 1447658877 | Center for Vein Restoration Pa Pllc | Surgery | 1338 Bristol Pike Ste 205, Bensalem, PA 19020-5679 | 2014-12-17 |
| 1023423167 | Catherine Go | Surgery | 420 S Aiken Ave, Apt A6, Pittsburgh, PA 15232-1226 | 2014-06-27 |
| 1659703635 | Walter J. Fagan | Surgery | 211 Center Ave, Jim Thorpe, PA 18229-1205 | 2013-08-01 |
| 1346521267 | Usa Vein Clinics of Philadelphia LLC | Surgery | 51 Cameron Rd, Huntingdon Valley, PA 19006-1401 | 2011-09-06 |
| 1124314893 | Nathan Loren Liang | Surgery | 200 Lothrop St # A-1017, Pittsburgh, PA 15213-2536 | 2011-06-21 |
| Find all providers with the same taxonomy | ||||
| City | WILKES-BARRE |
| Zip Code | 18711 |
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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.