Provider Demographics
NPI:1821110867
Name:KODA, STEVEN P (ND)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:P
Last Name:KODA
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 TARRYTOWN RD # 1516
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1313
Mailing Address - Country:US
Mailing Address - Phone:866-362-5632
Mailing Address - Fax:866-362-5632
Practice Address - Street 1:200 S BROADWAY STE 205
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4504
Practice Address - Country:US
Practice Address - Phone:866-362-5632
Practice Address - Fax:866-362-5632
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT1286175F00000X
VT099.0058707175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath