Provider Demographics
NPI:1588925424
Name:GELL-BODIN, JODY S (BS)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:S
Last Name:GELL-BODIN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SUTTON PL
Mailing Address - Street 2:APT 2H
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2304
Mailing Address - Country:US
Mailing Address - Phone:917-208-0510
Mailing Address - Fax:
Practice Address - Street 1:40 SUTTON PL
Practice Address - Street 2:APT 2H
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2304
Practice Address - Country:US
Practice Address - Phone:917-208-0510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator