Modak, Rajiv

Modak, Rajiv is an individual health care provider with primary practice located at 1500 W Commerce Ct , Tucson AZ 85746-6015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Modak, Rajiv can be contacted via phone (520) 670-3909.

Contact Information

Primary practice address
1500 W Commerce Ct Tucson AZ 85746-6015
Fax: (520) 806-2625
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 28426 Arizona

Profile Details

NPI number 1124002324
LBN Legal business name Modak, Rajiv
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Oct 19th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124002324 NPPES
Arizona MEDICAID 527690

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