Individual
DR. LISA M. KODADEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
330 CEDAR ST, BOARDMAN BUILDING 310, NEW HAVEN, CT 06510
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
65084
CT
2086S0102X
Surgical Critical Care Physician
65084
CT
2086S0127X
Trauma Surgery Physician
Primary
65084
CT
Other
Enumeration date
03/18/2011
Last updated
09/18/2020
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