Individual
KEYUR MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1036 AMBOY AVE, EDISON, NJ 08837-2870
(732) 225-2300
Mailing address
1036 AMBOY AVE, EDISON, NJ 08837-2870
(732) 225-2300
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
22DI02686700
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/30/2017
Last updated
04/26/2022
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