Individual
CODY ARCHIBALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
928 BROADWAY, NEW YORK, NY 10010-6008
(810) 543-2250
Mailing address
928 BROADWAY, NEW YORK, NY 10010-6008
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
024283
NY
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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