Organization
CANDID MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BODO PYKO M.D. (MEDICAL DIRECTOR)
(770) 994-1250
Entity
Organization
Contact information
Practice address
6525 PROFESSIONAL PL, SUITE C, RIVERDALE, GA 30274-2519
(770) 994-1250
Mailing address
500 W MAIN ST, SUITE 108, BABYLON, NY 11702-3027
(631) 930-5215
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
11/30/2012
Last updated
11/30/2012
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