| Doctor Name: | MS. MIJUNG JUDI SONG |
| NPI Number: | 1316278344 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.P.T |
| License Number: | 40QA01302400 |
| Business Practice Address: | 19-21 Fair Lawn Ave Suite 1c Fair Lawn, NJ - 074102331 |
| Business Phone Number: | 2017967772 |
| Business Fax Number: | |
| Mailing Address: | 453 5th St, PALISADES PARK |
| State: | NJ |
| Postal Code: | 076502317 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/14/2010 |
| NPI Last Update Date: | 01/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 40QA01302400 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |