Individual
MRS. DIANE MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR CHT
Contact information
Practice address
1373 BROAD STREET, SUITE 302, CLIFTON, NJ 07013
(973) 773-4263
(973) 773-4336
Mailing address
72 WHITFORD AVENUE, NUTLEY, NJ 07110
(973) 542-1450
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00190911
NJ
225XH1200X
Hand Occupational Therapist
Primary
9209001871
—
Other
Enumeration date
12/04/2006
Last updated
09/11/2025
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