Modest, Vicki Ellen

Modest, Vicki Ellen is an individual health care provider with primary practice located at 55 Fruit St Cln 3, Boston MA 02114-2621. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as her primary health care specialty. Modest, Vicki Ellen can be contacted via phone (617) 726-3030.

Contact Information

Primary practice address
55 Fruit St Cln 3 Boston MA 02114-2621
Phone: (617) 726-3030
Fax: (617) 726-7536
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 153069 Massachusetts

Profile Details

NPI number 1376525311
LBN Legal business name Modest, Vicki Ellen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 16th, 2005
Last updated Dec 14th, 2011 - about 15 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1376525311 NPPES
Massachusetts Other 766987 TUFTS HEALTH PLAN
Massachusetts Other J17346 TUFTS HEALTH PLAN
Massachusetts MEDICAID 3162729 TUFTS HEALTH PLAN

Popular Providers