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1184117004
BRENTON JAY SEUNG HOON SONG
ERIE, PA
NPI
1184117004
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry
(Licence: PA OS021405)
Enumeration Date
2018-06-14
Last Update Date
2023-05-31
Business Address
BRENTON JAY SEUNG HOON SONG DO
4740 PEACH ST
ERIE, PA 16509-2008
Phone number: 814-454-3174
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Mailing Address
BRENTON JAY SEUNG HOON SONG DO
1 LECOM PL
ERIE, PA 16505-2571
Phone number: 814-868-2529
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