Individual
DR. NITA MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 CENTRAL AVE, NEWARK, NJ 07102-1909
(973) 877-5000
Mailing address
3998 FAIR RIDGE DR, STE 300, FAIRFAX, VA 22033-2921
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA61617
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6670601
—
NJ
Enumeration date
07/07/2005
Last updated
03/19/2015
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