Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | A87354 | CA |
Y | 207YP0228X | Pediatric Otolaryngology | 036.117122 | IL |
NPI | 1609925403 |
---|---|
Provider Name | Dr. Vikash K Modi |
First Address | New York, NY 10021-5663 |
Second Address | New York, NY 10021-5663 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 09/12/2011 |