Individual
DR. TEJAL MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
101 APPLIED BANK BLVD STE 11, NEMOURS DUPONT PEDIATRICS, GLEN MILLS, GLEN MILLS, PA 19342-3501
(484) 800-8630
(484) 800-8635
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
25MA10023300
NJ
2085P0229X
Pediatric Radiology Physician
C10011787
DE
2085P0229X
Pediatric Radiology Physician
Primary
MD459411
PA
2085P0229X
Pediatric Radiology Physician
ME118748
FL
2085R0202X
Diagnostic Radiology Physician
ME118748
FL
2085R0202X
Diagnostic Radiology Physician
P7163
TX
Other
Enumeration date
07/09/2008
Last updated
02/23/2017
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