Bodamer, Wayne Joseph

Bodamer, Wayne Joseph is an individual health care provider with primary practice located at 373 Route 111 , Smithtown NY 11787-4759. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Bodamer, Wayne Joseph can be contacted via phone (631) 265-8802.

Contact Information

Primary practice address
373 Route 111 Smithtown NY 11787-4759
Phone: (631) 265-8802
Fax: (631) 265-8809
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 003889 New York

Profile Details

NPI number 1457317562
LBN Legal business name Bodamer, Wayne Joseph
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Nov 27th, 2007 - about 17 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 1457317562 NPPES
New York Other PPD162 HEALTHNET
New York Other AH00139 HEALTHNET
New York Other P41901 HEALTHNET
New York Other 0056853 HEALTHNET
New York Other 0301399-007 HEALTHNET
New York Other 96401 HEALTHNET
New York Other P368761 HEALTHNET

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