Healthcare Provider Details

I. General information

NPI: 1508903188
Provider Name (Legal Business Name): STEPHEN HOODY DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 BROADWAY BLDG 6TH FLOOR STE 600
NEW YORK NY
10038-4201
US

IV. Provider business mailing address

430 GRANT AVE
ORADELL NJ
07649-1838
US

V. Phone/Fax

Practice location:
  • Phone: 212-227-3350
  • Fax: 212-227-3379
Mailing address:
  • Phone: 201-225-0143
  • Fax: 212-227-3379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NN1001X
TaxonomyNutrition Chiropractor
License Number4154
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: