Individual
HIREN MODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(203) 276-7010
Mailing address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(230) 276-7298
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
041508
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010041508CT01
ANTHEM
CT
01
—
041508
CCI
CT
01
—
2V4055
HEALTH NET
CT
01
—
3308340
AETNA - HMO
CT
01
—
7043515
AETNA - PPO
CT
01
—
90S67
EMPIRE BC/BS
CT
01
—
9721521
CIGNA
CT
01
—
P00111131
RR MEDICARE
CT
01
—
P3151623
OXFORD
CT
01
—
TIN
UNITED
—
Enumeration date
09/27/2006
Last updated
10/10/2007
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