Individual
SUSHIL S. MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
175 E BROWN ST, SUITE 108, E STROUDSBURG, PA 18301-3098
(570) 476-3585
(570) 421-9014
Mailing address
5545 BRIDLE RD, STROUDSBURG, PA 18360-9197
(570) 793-3254
(866) 471-3154
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD422414
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1009422450002
—
PA
Enumeration date
03/21/2006
Last updated
02/29/2012
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