Individual
KAUSHIK CHHAGANLAL MODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
449 MOUNT PLEASANT AVE, 2ND FLOOR, WEST ORANGE, NJ 07052-2723
(973) 731-7868
(973) 731-7907
Mailing address
449 MOUNT PLEASANT AVE, 2ND FLOOR, WEST ORANGE, NJ 07052-2723
(973) 731-7868
(973) 731-7907
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
25MA05857500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6957901
—
NJ
Enumeration date
07/28/2005
Last updated
09/12/2013
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