| Raouf Kodsy, M.d. Physician Pc | |
|
1703 Genesee St Utica NY 13501 | |
| (315) 736-0155 | |
| (315) 732-0393 |
| Full Name | Raouf Kodsy, M.d. Physician Pc |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 1703 Genesee St, Utica, New York |
| Authorized Official Name and Position | Raouf Kodsy (PRESIDENT) |
| Authorized Official Contact | 3157360155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raouf Kodsy, M.d. Physician Pc Po Box 8155 Utica NY 13505 Ph: (315) 736-0155 | Raouf Kodsy, M.d. Physician Pc 1703 Genesee St Utica NY 13501 Ph: (315) 736-0155 |
| NPI Number | 1518190453 |
|---|---|
| Provider Enumeration Date | 08/26/2009 |
| Last Update Date | 02/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518190453 | NPI | - | NPPES |
| 03411061 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | 200560-1 (New York) | Primary |
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Douglas Ahn, M.d., P.l.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 122 Business Park Dr, Suite 1, Utica, NY 13502 Phone: 315-738-7883 Fax: 315-738-0347 | |
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