Individual
DR. JAYESH RAMANLAL MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 WEBSTER AVE, SUITE 306, POUGHKEEPSIE, NY 12601-1361
(845) 483-5934
(845) 483-5738
Mailing address
45 CATHY RD, POUGHKEEPSIE, NY 12603-4025
(845) 485-2028
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
141727
NY
2086S0129X
Vascular Surgery Physician
Primary
141727
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00782614
—
NY
Enumeration date
11/11/2005
Last updated
07/21/2021
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