Individual
RAJ K MODAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BLDG, NEW HAVEN, CT 06519-1369
(203) 785-2140
(203) 785-6414
Mailing address
PO BOX 9805, 300 GEORGE ST 6TH FLR, NEW HAVEN, CT 06536-0805
(203) 785-7998
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
038177
CT
207L00000X
Anesthesiology Physician
Primary
ME157402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001381772
—
CT
Enumeration date
07/11/2006
Last updated
09/16/2022
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