Individual
DR. SHAILJA MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820
(732) 321-7641
Mailing address
331 NEWMAN SPRINGS RD, BLDG 2, STE 220, RED BANK, NJ 07701-5688
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MB11619200
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2020
Last updated
10/31/2024
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