Modlin, Irvin M

Modlin, Irvin M is an individual health care provider with primary practice located at 789 Howard Ave Fitkin Building - 2Nd Floor, New Haven CT 06519-1304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Modlin, Irvin M can be contacted via phone (203) 785-3207.

Contact Information

Primary practice address
789 Howard Ave Fitkin Building - 2Nd Floor New Haven CT 06519-1304
Phone: (203) 785-3207
Fax: (203) 785-3826
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 025885 Connecticut

Profile Details

NPI number 1265418941
LBN Legal business name Modlin, Irvin M
Credentials MD PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Mar 16th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265418941 NPPES
Connecticut MEDICAID 001258854

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