Individual
PAYAL K. MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 421-1400
(508) 421-1490
Mailing address
25 SAINT MARYS ST, NEWTON, MA 02462-1018
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
258647
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110100054A
—
MA
Enumeration date
06/02/2010
Last updated
08/30/2023
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