Healthcare Provider Details

I. General information

NPI: 1568856425
Provider Name (Legal Business Name): PABLO SEBASTIAN CODNER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2015
Last Update Date: 10/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 WEST 168TH STREET - NEW YORK PRESBYTERIAN HOSPITAL INTERVENTIONAL CARDIOLOGY DEPARTMENT
NEW YORK NY
10032
US

IV. Provider business mailing address

622 WEST 168TH STREET PRESBYTERIAN HOSPITAL INTERVENTIONAL CARDIOLOGY
NEW YORK NY
10032
US

V. Phone/Fax

Practice location:
  • Phone: 212-305-2500
  • Fax:
Mailing address:
  • Phone: 212-342-4260
  • Fax: 212-342-4272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: