Individual
DR. WAYNE JOSEPH BODAMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
373 ROUTE 111, SMITHTOWN, NY 11787-4759
(631) 265-8802
(631) 265-8809
Mailing address
1641 ROUTE 112, MEDFORD, NY 11763-3635
(631) 447-0800
(631) 447-0801
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
003889
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0056853
GHI
NY
01
—
0301399-007
CIGNA HMO
NY
01
—
96401
AETNA US HEALTHCARE
NY
01
—
AH00139
MDNY
NY
01
—
P368761
OXFORD HEALTH PLAN
NY
01
—
P41901
EMPIRE BLUECROSS/BLUE SHI
NY
01
—
PPD162
HEALTHNET
NY
Enumeration date
04/26/2006
Last updated
11/27/2007
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