Provider Demographics
NPI:1013915529
Name:MODI, KALPANA (MD)
Entity Type:Individual
Prefix:
First Name:KALPANA
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 1:1 WEBSTER AVE STE 505
Mailing Address - Street 2:BEDFORD ANESTHESIA PLLC
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-1363
Mailing Address - Country:US
Mailing Address - Phone:845-452-0555
Mailing Address - Fax:845-452-0550
Practice Address - Street 1:1 WEBSTER AVE STE 505
Practice Address - Street 2:BEDFORD ANESTHESIA PLLC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-1363
Practice Address - Country:US
Practice Address - Phone:845-452-0555
Practice Address - Fax:845-452-0550
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY163632207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00914778Medicaid
NY00914778Medicaid
NYA63105Medicare UPIN