Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | 25MA10494900 | NJ |
NPI | 1265741276 |
---|---|
Provider Name | Dr. Kalgi Mody |
First Address | Park Ridge, NJ 07656-2137 |
Second Address | Mineola, NY 11501-3647 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2010 |
Last Update Date | 20/02/2019 |