Individual
MR. DARRYK JAMES MODRACEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
593 EDDY ST, RHODE ISLAND HOSPITAL. DEPT OF CARDIAC SURGERY (CTIC), PROVIDENCE, RI 02903-4923
(401) 444-5150
Mailing address
38 DR BRALEY RD, ROCHESTER, MA 02770-1900
(508) 858-8910
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA00313
RI
Other
Enumeration date
05/09/2007
Last updated
03/14/2014
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