Organization
RAJ MODI M.D. P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJENDRA MODI M.D. (PHYSICIAN)
(718) 456-2020
Entity
Organization
Contact information
Practice address
55 44 METROPOLITAN AVE., RIDGEWOOD, NY 11385-1221
(718) 456-2020
(718) 821-5342
Mailing address
55 44 METROPOLITAN AVE., RIDGEWOOD, NY 11385-1221
(718) 456-2020
(718) 821-5342
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
154743
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03315235
—
NY
01
—
171837
ELDERPLAN
NY
01
—
738B51
EMPIRE BCBS
NY
01
—
DS376
OXFORD
NY
Enumeration date
01/26/2011
Last updated
06/14/2011
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