Individual
CORY DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
314 EVERGREEN AVE APT 4B, BROOKLYN, NY 11221-8352
(631) 974-5446
Mailing address
314 EVERGREEN AVE APT 4B, BROOKLYN, NY 11221-8352
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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