| Doctor Name: | DAVID ROEDER |
| NPI Number: | 1194747469 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | C-042014 |
| Business Practice Address: | 201 Cedar St Oneida, NY - 134212111 |
| Business Phone Number: | 3153618413 |
| Business Fax Number: | 3153618450 |
| Mailing Address: | 201 Cedar St, ONEIDA |
| State: | NY |
| Postal Code: | 134212111 |
| Phone Number: | 3153618413 |
| Fax Number: | 3153618450 |
| NPI Enumeration Date: | 07/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | C-042014 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |