Doctor Name: | KOKILA MODY |
NPI Number: | 1104894146 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 1136241 |
Business Practice Address: | 1 Edgewater Plaza 1st Fl. Lab Staten Island, NY - 10305 |
Business Phone Number: | 7182264130 |
Business Fax Number: | 7182264185 |
Mailing Address: | 1 Edgewater St, 6th Fl. Payer Relations STATEN ISLAND |
State: | NY |
Postal Code: | 103054900 |
Phone Number: | 7182261008 |
Fax Number: | 7182261039 |
NPI Enumeration Date: | 03/08/2006 |
NPI Last Update Date: | 05/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1136241 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |