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

Teresa Song, MD

Individual provider Dermatology Physician · NPI 1679136790

Teresa Song, MD is a Dermatology in New York, New York. Graduated from State University of New York Downstate Medical Center in 2019, 7 years ago. Practices as a sole proprietor. Licensed in New York.

Years since qualifying
7
Trained at
State University of New York Downstate Medical Center
Licensed in
NY
In the registry since
2019
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12 E 87th St Apt 1A
New York, NY 10128-0501
Phone: (212) 996-6900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 321001 (NY)

Record details

NPI number1679136790
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 15, 2019
Last updated in NPPESDecember 10, 2025
Certification dateDecember 10, 2025

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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