Individual
DR. GREGORY BRENT DODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 CENTRAL PARK WEST, SUITE 14, NEW YORK CITY, NY 10023-4198
(212) 877-2100
(212) 873-9311
Mailing address
115 CENTRAL PARK WEST, SUITE 14, NEW YORK CITY, NY 10023-4198
(212) 877-2100
(212) 873-9311
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
257597-1
NY
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
257597-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04229067
—
NY
01
—
1053622449
NPI
NY
Enumeration date
06/30/2010
Last updated
08/04/2023
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