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Individual

MR. STEWART GOULD CODDINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN, MS, CDE

Contact information

Practice address
ONE OVERLOOK AVENUE, SUITE 1-0, GREAT NECK, NY 11021-3750
(516) 902-3393
(516) 498-9688
Mailing address
ONE OVERLOOK AVENUE, SUITE 1-0, GREAT NECK, NY 11021-3750
(516) 902-3393
(516) 498-9688

Taxonomy

Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
526929
NY
163WH0200X
Home Health Registered Nurse
526929
NY
163WS0200X
School Registered Nurse
526929
NY

Other

Enumeration date
02/03/2009
Last updated
02/11/2009
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