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General NPI Number Information
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NPI Number | 1902077969
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Entity Type | Organization
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Legal Business Name | DODIS KOHAN, MD PC
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Dates
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Enumeration Date | 03/18/2008
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Last Update Date | 11/19/2009
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Provider Practice Location Address
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Address Line | 518 HAWKINS AVE
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City | RONKONKOMA
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State | NY
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Zip | 11779-2327
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Country | US
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Telephone | 631-676-7390
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Fax | 631-676-7388
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Provider Business Mailing Address
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Address Line | 11 DUMBARTON DR
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City | HUNTINGTON
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State | NY
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Zip | 11743-2468
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Country | US
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Telephone | 631-676-7390
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Fax | 631-676-7388
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DODIS KOHAN
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Credential | M.D.
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Telephone | 631-676-7390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 148282
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License Number State | NY
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