Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 249685 | NY |
N | 111NI0900X | Internist | 249685 | NY |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 25MA09537200 | NJ |
NPI | 1891941449 |
---|---|
Provider Name | Kanika Pravin Mody |
First Address | Allendale, NJ 07401-1342 |
Second Address | Hackensack, NJ 07601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 08/01/2019 |