Individual
DR. SCOTT CHRISTOPHER WODICKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750
Mailing address
15 PARK AVE, BAY SHORE, NY 11706-7381
(631) 581-4400
(631) 277-3750
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
214088
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214088
LICENSE
NY
Enumeration date
06/22/2006
Last updated
08/20/2010
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