Individual
JAYSHREE MODI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
434 DEKALB AVE, LAFAYETTE CHC, BROOKLYN, NY 11205-4406
(718) 638-8258
(718) 783-6524
Mailing address
894 BARD AVE, STATEN ISLAND, NY 10301-3321
(718) 727-9346
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
180623
NY
Other
Enumeration date
07/11/2006
Last updated
07/08/2007
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