Organization
RAOUF KODSY, M.D. PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAOUF KODSY MD (PRESIDENT)
(315) 736-0155
Entity
Organization
Contact information
Practice address
1703 GENESEE ST, UTICA, NY 13501
(315) 736-0155
(315) 732-0393
Mailing address
PO BOX 8155, UTICA, NY 13505
(315) 736-0155
(315) 732-0393
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
200560-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03411061
—
NY
Enumeration date
08/26/2009
Last updated
02/18/2013
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