Organization
BODIAN DERMATOLOGY GROUP, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ADAM BEN BODIAN II MD (PRESIDENT)
(516) 482-2882
Entity
Organization
Contact information
Practice address
11 GRACE AVE, SUITE 100, GREAT NECK, NY 11021-2417
(516) 482-2882
(516) 482-6039
Mailing address
11 GRACE AVE, SUITE 100, GREAT NECK, NY 11021-2417
(516) 482-2882
(516) 482-6039
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
176289
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN7593
RAILROAD MEDICARE
NY
Enumeration date
02/09/2007
Last updated
05/29/2008
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