Individual provider · NPI-1

Dr. Kenneth Alan Bodkin, Au.D.

Audiologist · Hackensack, NJ

NPI number1427199140
StatusActive
Last updated in NPPESAug 21, 2008

Details

NPI
1427199140
Entity type
Individual (NPI-1)
Name
Dr. Kenneth Alan Bodkin
Credential
Au.D.
Sex
Male
Sole proprietor
No
Enumeration date
Feb 8, 2007
Last updated
Aug 21, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
231H00000X AudiologistYA000577NJYes
231H00000X Audiologist1552NY
237600000X Audiologist-Hearing Aid Fitter25MG00090100NJ

Practice location

30 Prospect Ave.
Dept. Of Audiology
Hackensack, NJ 07601

Phone 201-996-5126 · Fax 201-996-0557

Mailing address

20 Prospect Ave
Suite 808
Hackensack, NJ 07601-1997

Phone 201-996-5126 · Fax 201-996-0557

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