Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Boram Song

Individual provider Family Nurse Practitioner · NPI 1063894475

Boram Song is a Nurse Practitioner in Englewood, New Jersey. Qualified in 2014, 12 years ago. Practices with Perry Ave Family Medical Center Inc, a 28-clinician group and works from 2 locations. Licensed in New Jersey and New York.

Years since qualifying
12
Licensed in
NJ, NY
In the registry since
2015
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

200 Grand Ave Ste 201
Englewood, NJ 07631-4363
Phone: (201) 944-3800
Fax: (201) 944-3804
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 243 Chestnut St, Newark, NJ 07105-6501 — (201) 944-3800

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ00890500 (NJ)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence F339122 (NY)

Record details

NPI number1063894475
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 22, 2015
Last updated in NPPESSeptember 8, 2022
Certification dateSeptember 8, 2022
Mailing address200 Grand Ave Ste 201, Englewood, NJ 07631-4363

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Perry Ave Family Medical Center Inc — 28 clinicians
Accepts Medicare assignment Not indicated

Other providers in Englewood