John J Bodkin, Ii, Md, Llc | |
5667 Creekwood Ct East East Amherst NY 14051 | |
(716) 689-1864 | |
Not Available |
Full Name | John J Bodkin, Ii, Md, Llc |
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Speciality | Family Medicine |
Location | 5667 Creekwood Ct East, East Amherst, New York |
Authorized Official Name and Position | John J Bodkin (OWNER) |
Authorized Official Contact | 7166891864 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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John J Bodkin, Ii, Md, Llc 5667 Creekwood Ct East East Amherst NY 14051 Ph: (716) 689-1864 | John J Bodkin, Ii, Md, Llc 5667 Creekwood Ct East East Amherst NY 14051 Ph: (716) 689-1864 |
NPI Number | 1689426322 |
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Provider Enumeration Date | 04/04/2024 |
Last Update Date | 04/04/2024 |
Medicare PECOS PAC ID | 8325579436 |
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Medicare Enrollment ID | O20241001000183 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689426322 | NPI | - | NPPES |
00637274 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | John J Bodkin |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1609831536 PECOS PAC ID: 6507845161 Enrollment ID: I20110216000277 |
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