Michael L Wodka D.P.M. PC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

N003161-1 Issued in NY

Legal business name

MICHAEL L WODKA D.P.M. PC

Practice address

30 Industrial Dr
Middletown, NY 10941-1662

Phone

(845) 692-3338

NPI assigned

Jan 30, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael L Wodka, D.P.M.

Title

President

Phone

(845) 692-3338

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201651200000",
    "number": "1891972089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 INDUSTRIAL DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411662",
            "telephone_number": "845-692-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 INDUSTRIAL DR",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109411662",
            "telephone_number": "845-692-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L WODKA D.P.M. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2008-01-30",
        "status": "A",
        "authorized_official_last_name": "WODKA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-692-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NY",
            "license": "N003161-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00554738",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Middletown, NY
• Providers in Middletown, NY by specialty
• Primary Podiatric Medicine Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.