| 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 |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 04/04/2024 |
| Last Update Date | 04/04/2024 |
| Medicare PECOS PAC ID | 8325579436 |
|---|---|
| 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 |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609831536 PECOS PAC ID: 6507845161 Enrollment ID: I20110216000277 |
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