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Individual

KENNETH S OZDOBA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1500 WATERS PL, BRONX, NY 10461-2723
(718) 931-0600
Mailing address
300 E 75TH ST, NEW YORK, NY 10021-3375

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
235765
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
235765
NY
Enumeration date
06/04/2007
Last updated
07/08/2007
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