Bodack, Mark P

Bodack, Mark P is an individual health care provider with primary practice located at 1 Webster Ave Atrium At Sfh, Poughkeepsie NY 12601-1361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Bodack, Mark P can be contacted via phone (845) 483-5780.

Contact Information

Primary practice address
1 Webster Ave Atrium At Sfh Poughkeepsie NY 12601-1361
Phone: (845) 483-5780
Fax: (845) 483-5787
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 196328 New York

Profile Details

NPI number 1386635829
LBN Legal business name Bodack, Mark P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Mar 1st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386635829 NPPES
New York MEDICAID 01849729

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