Individual
JOANNA J ODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
400 S OYSTER BAY RD, SUITE 305, HICKSVILLE, NY 11801-3500
(516) 939-6100
(516) 939-2510
Mailing address
400 S OYSTER BAY RD, SUITE 305, HICKSVILLE, NY 11801-3500
(516) 939-6100
(516) 939-2510
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
244872
NY
207W00000X
Ophthalmology Physician
D63313
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02914914
—
NY
01
—
098751
MEDICARE PROVIDER ID
NY
05
—
408613900
—
MD
Enumeration date
05/18/2006
Last updated
01/04/2022
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