Provider Demographics
NPI:1356461305
Name:MODITI, ZACHARO (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARO
Middle Name:
Last Name:MODITI
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 1:315 NORWOOD PARK S STE 201
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-4681
Mailing Address - Country:US
Mailing Address - Phone:781-414-4150
Mailing Address - Fax:781-414-4151
Practice Address - Street 1:315 NORWOOD PARK S STE 201
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:MA
Practice Address - Zip Code:02062-4681
Practice Address - Country:US
Practice Address - Phone:781-414-4150
Practice Address - Fax:781-414-4151
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA256681207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology