Individual
ANJU GUPTA-MODAK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2844
(718) 283-8853
(718) 635-7235
Mailing address
977 48TH ST, BROOKLYN, NY 11219-2919
(718) 283-8015
(718) 635-7235
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
225285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001131
HIP
NY
01
—
001131-A15
HEALTH FIRST
NY
05
—
02109608
—
NY
01
—
0B7762
EMPIRE BCBS
NY
01
—
1000030331
AFFINITY HEALTH PLAN
NY
01
—
2603107
GHI
NY
01
—
26N9651
NEIGHBORHOOD HEALTH
NY
01
—
4C4442
HEALTH NET
NY
01
—
GA5285
ATLANTIS HEALTH PLAN
NY
01
—
P2068431
OXFORD HEALTH PLANS
NY
Enumeration date
09/13/2005
Last updated
07/08/2007
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