Provider Demographics
NPI:1073751756
Name:CODDINGTON, STEWART GOULD (RN, MS, CDE)
Entity Type:Individual
Prefix:MR
First Name:STEWART
Middle Name:GOULD
Last Name:CODDINGTON
Suffix:
Gender:M
Credentials:RN, MS, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ONE OVERLOOK AVENUE
Mailing Address - Street 2:SUITE 1-0
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-3750
Mailing Address - Country:US
Mailing Address - Phone:516-902-3393
Mailing Address - Fax:516-498-9688
Practice Address - Street 1:ONE OVERLOOK AVENUE
Practice Address - Street 2:SUITE 1-0
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-3750
Practice Address - Country:US
Practice Address - Phone:516-902-3393
Practice Address - Fax:516-498-9688
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY526929163WD0400X, 163WH0200X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WS0200XNursing Service ProvidersRegistered NurseSchool