Provider Demographics
NPI:1114153889
Name:CODDINGTON OFFICE BASED SURGERY, PC
Entity Type:Organization
Organization Name:CODDINGTON OFFICE BASED SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RADHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-351-1350
Mailing Address - Street 1:5 CODDINGTON AVENUE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306
Mailing Address - Country:US
Mailing Address - Phone:718-351-1350
Mailing Address - Fax:718-351-1271
Practice Address - Street 1:5 CODDINGTON AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-4305
Practice Address - Country:US
Practice Address - Phone:718-351-1350
Practice Address - Fax:718-351-1271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical