Chudasama-Modi, Shivangi A

Chudasama-Modi, Shivangi A is an individual health care provider with primary practice located at 100 Horwood Pl , Ogdensburg NY 13669-4510. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Chudasama-Modi, Shivangi A can be contacted via phone (315) 394-9462.

Contact Information

Primary practice address
100 Horwood Pl Ogdensburg NY 13669-4510
Phone: (315) 394-9462
Fax: (315) 713-5291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 341857 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 341857 New York

Profile Details

NPI number 1548782931
LBN Legal business name Chudasama-Modi, Shivangi A
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2017
Last updated Sep 12th, 2022 - about 2 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 1548782931 NPPES
New York MEDICAID 04911033

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