Healthcare Provider Details

I. General information

NPI: 1205239431
Provider Name (Legal Business Name): FRANCIS ZODDA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 55TH ST
BROOKLYN NY
11220-3107
US

IV. Provider business mailing address

460 55TH ST
BROOKLYN NY
11220-3107
US

V. Phone/Fax

Practice location:
  • Phone: 718-492-6016
  • Fax:
Mailing address:
  • Phone: 718-492-6016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RM2200X
TaxonomyMedical Laboratory Technician
License Number0081081
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: