Individual
WILLIAM RAYMOND BODNER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 POPLAR ST, BRONX, NY 10461-2653
(718) 405-8550
Mailing address
193 KEELER DR, RIDGEFIELD, CT 06877-1009
(203) 790-6637
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
191249
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01632975
—
NY
Enumeration date
01/11/2007
Last updated
07/08/2007
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