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General NPI Number Information
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NPI Number | 1801056619
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Entity Type | Organization
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Legal Business Name | STEVEN A. ODRICH,MD, MARC G. ODRICH, MD, PC
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Dates
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Enumeration Date | 06/16/2008
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Last Update Date | 03/02/2016
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Provider Practice Location Address
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Address Line | 3765 RIVERDALE AVE
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City | BRONX
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State | NY
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Zip | 10463-1845
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Country | US
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Telephone | 718-432-2020
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Fax | 718-432-8482
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Provider Business Mailing Address
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Address Line | 3765 RIVERDALE AVE
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City | BRONX
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State | NY
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Zip | 10463-1845
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Country | US
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Telephone | 718-432-2020
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Fax | 718-432-8482
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. FLORENCE A HATTASCH
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Credential |
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Telephone | 718-432-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 163491
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 179385
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License Number State | NY
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