Provider Demographics
NPI:1114313632
Name:MODI, NEHA (MD)
Entity Type:Individual
Prefix:
First Name:NEHA
Middle Name:
Last Name:MODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE BROOKDALE PLAZA
Mailing Address - Street 2:SURGERY EDUCATION/DEPARTMENT OF SURGERY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212
Mailing Address - Country:US
Mailing Address - Phone:718-240-5000
Mailing Address - Fax:718-240-6738
Practice Address - Street 1:ONE BROOKDALE PLAZA
Practice Address - Street 2:SURGERY EDUCATION/DEPARTMENT OF SURGERY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212
Practice Address - Country:US
Practice Address - Phone:718-240-5000
Practice Address - Fax:718-240-6738
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2016-01-26
Deactivation Date:2015-11-13
Deactivation Code:
Reactivation Date:2016-01-26
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program