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General NPI Number Information
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NPI Number | 1245561778
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Entity Type | Individual
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Provider Name | TODD COWDERY MD
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Gender | Male
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Dates
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Enumeration Date | 01/22/2010
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Last Update Date | 02/15/2017
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Provider Practice Location Address
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Address Line | 1790 BROADWAY STE 1802
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City | NEW YORK
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State | NY
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Zip | 10019-1471
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Country | US
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Telephone | 212-530-0624
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Fax | 212-867-4353
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Provider Business Mailing Address
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Address Line | 1790 BROADWAY STE 1802
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City | NEW YORK
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State | NY
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Zip | 10019-1471
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Country | US
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Telephone | 212-530-0624
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Fax | 212-867-4353
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 234216
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License Number State | NY
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