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Individual

DR. JODI E KODISH-WACHS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
42 LAUREL RD E, UDP #1700, STRATFORD, NJ 08084-1354
(856) 566-7010
(856) 566-6956
Mailing address
PO BOX 635, BELLMAWR, NJ 08099-0635
(856) 770-5772
(856) 566-2797

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MA07556200
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0030813
NJ
Enumeration date
01/23/2006
Last updated
07/08/2007
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