Provider Demographics
NPI:1811713423
Name:MODY, MANSI
Entity type:Individual
Prefix:
First Name:MANSI
Middle Name:
Last Name:MODY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A 8, SANTKRUPA SOCIETY
Mailing Address - Street 2:MAKTAMPUR
Mailing Address - City:BHARUCH
Mailing Address - State:GUJARAT
Mailing Address - Zip Code:392012
Mailing Address - Country:IN
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:A 8, SANTKRUPA SOCIETY
Practice Address - Street 2:MAKTAMPUR
Practice Address - City:BHARUCH
Practice Address - State:GUJARAT
Practice Address - Zip Code:392012
Practice Address - Country:IN
Practice Address - Phone:919-664-8219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-27
Last Update Date:2024-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program