Edward J Modica, ATC,EMT-B
Specialist in Massapequa, NY. Individual provider (NPI-1).
NPI number1821312331
StatusActive
Last updated in NPPESMar 26, 2010
Details
- NPI
- 1821312331
- Entity type
- Individual (NPI-1)
- Name
- Mr. Edward J Modica
- Credential
- ATC,EMT-B
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 26, 2010
- Last updated
- Mar 26, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 000370-1 | NY | Yes |
Practice location
434 N Bleecker DrMassapequa, NY 11758-1340
Phone 516-721-6541
Mailing address
434 N Bleecker DrMassapequa, NY 11758-1340
Phone 516-721-6541
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