Individual
DR. PAUL MODICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
243 NORTH RD, SUITE 304, POUGHKEEPSIE, NY 12601-1172
(845) 471-9410
(845) 451-7757
Mailing address
243 NORTH RD, SUITE 304, POUGHKEEPSIE, NY 12601-1172
(845) 451-7251
(845) 451-7757
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
187853
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01305839
—
NY
Enumeration date
07/29/2005
Last updated
04/24/2015
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