# RAJ MODI M.D. P.C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952606774
- **Authorized official:** DR. RAJENDRA MODI M.D. (PHYSICIAN)
- **Authorized official phone:** (718) 456-2020

## Contact information

- **Practice address:** 55 44 METROPOLITAN AVE., RIDGEWOOD, NY 11385-1221
- **Practice address phone:** (718) 456-2020
- **Practice address fax:** (718) 821-5342
- **Mailing address:** 55 44 METROPOLITAN AVE., RIDGEWOOD, NY 11385-1221
- **Mailing address phone:** (718) 456-2020
- **Mailing address fax:** (718) 821-5342

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 154743 | NY | Yes |

## Other

- **Enumeration date:** 01/26/2011
- **Last updated:** 06/14/2011