Organization
KIP L BODI PHYSICIAN FACS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIP L BODI M.D.,F.A.C.S. (PRESIDENT)
(631) 271-1608
Entity
Organization
Contact information
Practice address
775 PARK AVE, SUITE 262, HUNTINGTON, NY 11743-3976
(631) 271-1608
(631) 271-1968
Mailing address
775 PARK AVE, SUITE 262, HUNTINGTON, NY 11743-3976
(631) 271-1608
(631) 271-1968
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
144782
NY
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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