Provider Demographics
NPI:1275215261
Name:MODANI CARE SD
Entity Type:Organization
Organization Name:MODANI CARE SD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-537-6106
Mailing Address - Street 1:1149 STATE ROUTE 17M STE 201
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-1432
Mailing Address - Country:US
Mailing Address - Phone:212-402-1061
Mailing Address - Fax:212-402-1062
Practice Address - Street 1:1149 STATE ROUTE 17M STE 201
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1432
Practice Address - Country:US
Practice Address - Phone:212-402-1061
Practice Address - Fax:212-402-1062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-01
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty