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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 1447315528 NPPES
New York MEDICAID 02708836

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