| NPI | 1881758225 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNEJ JOSEPH BODAMER President 631-265-8802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: NY no-3889) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2008-01-17 |