Healthcare Provider Details

I. General information

NPI: 1023909165
Provider Name (Legal Business Name): ODED HADAR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2025
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 E 102ND ST
NEW YORK NY
10029-5611
US

IV. Provider business mailing address

1 LEVIN KIPNIS, APT 11
TEL AVIV ISRAEL
69626
IL

V. Phone/Fax

Practice location:
  • Phone: 212-241-8462
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: