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Individual

PETER A BODI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
175 E CHESTER PIKE, RIDLEY PARK, PA 19078-2212
(610) 595-6586
(610) 595-6787
Mailing address
175 E CHESTER PIKE, RIDLEY PARK, PA 19078-2212
(610) 595-6586
(610) 595-6787

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA003157L
PA
363AS0400X
Surgical Physician Assistant
C5-0000626
DE

Other

Enumeration date
08/15/2005
Last updated
10/22/2012
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