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Individual

DR. MARK A GODECKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1522 OLD BURRSTONE RD, UTICA, NY 13502-4854
(315) 797-2450
(315) 792-4641
Mailing address
1522 OLD BURRSTONE RD, UTICA, NY 13502-4854
(315) 797-2450
(315) 792-4641

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
129980
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00561582
NY
Enumeration date
10/10/2006
Last updated
12/21/2012
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