Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 4154 | NY |
NPI | 1508903188 |
---|---|
Provider Name | Stephen Hoody |
First Address | Oradell, NJ 07649-1838 |
Second Address | New York, NY 10038-4201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 08/07/2007 |