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Individual

KIMBERLY BODENLOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
94 OLD SHORT HILLS RD, EAST WING, SUITE 402, LIVINGSTON, NJ 07039-1962
(973) 322-5287
Mailing address
94 OLD SHORT HILLS RD, EAST WING, SUITE 402, LIVINGSTON, NJ 07039-1962
(973) 322-5287

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
25MA10539800
NJ
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/31/2015
Last updated
04/08/2024
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