Individual
KANIKA PRAVIN MODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 PROSPECT AVE STE 200, HACKENSACK, NJ 07601
(551) 996-4849
(551) 996-8089
Mailing address
35 PINE RD, ALLENDALE, NJ 07401-1342
(551) 804-7679
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
249685
NY
207RA0001X
Advanced Heart Failure and Transplant Cardiology Physician
Primary
25MA09537200
NJ
Other
Enumeration date
08/14/2008
Last updated
01/08/2019
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