IndividualActive
Brenton Song, DO
NPI 1184117004 · Child & Adolescent Psychiatry Physician · Erie, PA
Provider details
- NPI number
- 1184117004
- Entity type
- Individual
- Primary specialty
- Child & Adolescent Psychiatry PhysicianAllopathic & Osteopathic Physicians
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- License
- OS021405 (PA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
4740 Peach St
Erie, PA 16509-2008
Phone: (814) 454-3174
Fax: (814) 616-8002
Approximate (ZIP-level) locationGet directions
Mailing address
1 Lecom Pl
Erie, PA 16505-2571
Additional practice locations (1)
- 537 W 18th StErie, PA 16502-1722Phone: (814) 454-3174Fax: (814) 616-8002
Registry dates
- Enumerated
- 2018-06-14
- Last updated
- 2023-05-31
- Certified
- 2023-05-31
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.