Modell, Lisa Renee
Modell, Lisa Renee is an individual health care provider with primary practice located at 1400 Pehham Pkwy So. Rm 3W7 Midwifery Office, Bronx NY 10461. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Modell, Lisa Renee can be contacted via phone (718) 918-6326.Contact Information
Primary practice address
1400 Pehham Pkwy So. Rm 3W7 Midwifery Office
Bronx NY 10461
Phone: (718) 918-6326
Fax: (718) 918-6318
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | 001199 | New York |
Profile Details
| NPI number | 1447315528 |
|---|---|
| LBN Legal business name | Modell, Lisa Renee |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Sep 8th, 2015 - about 10 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 | 1447315528 | NPPES |
| New York | MEDICAID | 02708836 |
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