Modayil, Philip
Modayil, Philip is an sole proprietor health care provider with primary practice located at 208 Roanoke Ave , Riverhead NY 11901-2706. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Modayil, Philip can be contacted via phone (631) 369-0104.Contact Information
Primary practice address
208 Roanoke Ave
Riverhead NY 11901-2706
Phone: (631) 369-0104
Fax: (631) 369-5433
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | NY127026 | New York |
Profile Details
| NPI number | 1447423769 |
|---|---|
| LBN Legal business name | Modayil, Philip |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 8th, 2008 |
| Last updated | Apr 8th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447423769 | NPPES |
| New York | MEDICAID | 00659412 |
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