Organization
BODHI MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN MALACHOVSKY M.D., M.P.H (PRESIDENT)
(917) 664-5607
Entity
Organization
Contact information
Practice address
330 W 58TH ST, SUITE #414, NEW YORK, NY 10019-1827
(212) 624-0220
(212) 624-0220
Mailing address
330 W 58TH ST, SUITE #414, NEW YORK, NY 10019-1827
(212) 624-0220
(212) 624-0220
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
218135
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01857152
—
NY
Enumeration date
10/03/2006
Last updated
09/23/2014
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