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General NPI Number Information
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NPI Number | 1376602383
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Entity Type | Organization
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Legal Business Name | RONALD MARK PODELL MD PC
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 01/27/2012
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Provider Practice Location Address
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Address Line | 40 EAGLES NEST
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City | COLD SPRING
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State | NY
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Zip | 10516
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Country | US
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Telephone | 845-265-7867
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Fax | 845-265-7867
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Provider Business Mailing Address
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Address Line | 40 EAGLES NEST
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City | COLD SPRING
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State | NY
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Zip | 10516
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Country | US
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Telephone | 845-265-7867
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Fax | 845-265-7867
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Authorized Official
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Title or Position | PRESIDENT
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Name | RONALD M PODELL
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Credential | MD
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Telephone | 845-265-7867
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 116175
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License Number State | NY
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