Modak, Prema
Modak, Prema is an individual health care provider with primary practice located at 3998 Fair Ridge Dr Ste 105 , Fairfax VA 22033-2980. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Modak, Prema can be contacted via phone (571) 349-2191.Contact Information
Primary practice address
3998 Fair Ridge Dr Ste 105
Fairfax VA 22033-2980
Phone: (571) 349-2191
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | D0070139 | Maryland |
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 0101240540 | Virginia |
Profile Details
| NPI number | 1689894578 |
|---|---|
| LBN Legal business name | Modak, Prema |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 26th, 2007 |
| Last updated | Jul 30th, 2019 - about 6 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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