Individual
DANIEL BODEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1308 MORRIS AVE STE 102, UNION, NJ 07083-3328
(908) 851-2770
Mailing address
634 QUINTON AVE, KENILWORTH, NJ 07033-1815
(203) 767-0948
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
25MB10134200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MB10134200
NJ LICENSE
NJ
Enumeration date
04/16/2014
Last updated
08/06/2021
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