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General NPI Number Information
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NPI Number | 1528273224
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Entity Type | Organization
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Legal Business Name | BAROUKH AND ROBERT E. KODSI, M.D., P.C.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 6010 BAY PARKWAY SUITE 804
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City | BROOKLYN
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State | NY
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Zip | 11204
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Country | US
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Telephone | 718-851-6767
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Fax | 718-851-5807
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Provider Business Mailing Address
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Address Line | 6010 BAY PARKWAY SUITE 804
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City | BROOKLYN
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State | NY
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Zip | 11204
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Country | US
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Telephone | 718-851-6767
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Fax | 718-851-5807
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | NATALIYA PLESHCHITSER
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Credential |
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Telephone | 718-851-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 194286-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 093855-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 008017-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 608017
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License Number State | NY
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Taxonomy #5
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 194286
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License Number State | NY
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