ANJU GUPTA-MODAK (NPI# 1891780276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891780276 |
| Entity Type | Individual |
| Full Name | ANJU GUPTA-MODAK |
| Credential | MD |
| Practice Address |
4802 10th Ave Brooklyn NY 11219-2844 |
| Mailing Address |
977 48th St Brooklyn NY 11219-2919 |
| Practice Telephone | 7182838853 |
| Practice Fax Number | 7186357235 |
| Mailing Telephone | 7182838015 |
| Mailing Fax Number | 7186357235 |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
225285 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | HIP | 001131 | 01 |
| NY | EMPIRE BCBS | 0B7762 | 01 |
| NY | HEALTH NET | 4C4442 | 01 |
| NY | OXFORD HEALTH PLANS | P2068431 | 01 |
| NY | GHI | 2603107 | 01 |
| NY | NEIGHBORHOOD HEALTH | 26N9651 | 01 |
| NY | 02109608 | 05 | |
| NY | AFFINITY HEALTH PLAN | 1000030331 | 01 |
| NY | ATLANTIS HEALTH PLAN | GA5285 | 01 |
| NY | HEALTH FIRST | 001131-A15 | 01 |
| Street Address |
4802 10TH AVE |
| City | BROOKLYN |
| State | NY |
| Zip Code | 11219-2844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316943871 | Samantha Paige Jellinek | Pharmacist | 4802 10th Ave, Brooklyn, NY 11219-2844 | 2005-06-21 |
| 1730789959 | Arjun Basnet | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-27 |
| 1679171623 | Shehanaz Shajahan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-13 |
| 1215534524 | Syed Mohammad Mazhar Uddin | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-10-08 |
| 1619581899 | Laurel Wright | Psychologist | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-09-03 |
| 1780296749 | Rabiah Ashraf | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-08-20 |
| 1275142820 | Jenna Danae Katherine Kroeker | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-29 |
| 1720696347 | Jay Donald Keith | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-20 |
| 1003424912 | Amit Dhaliwal | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| 1912515826 | Supraja Achuthanandan | Student in an Organized Health Care Education/Training Program | 4802 10th Ave, Brooklyn, NY 11219-2916 | 2020-07-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073127163 | Chava Bokchin | Registered Nurse | 6200 15th Avenue, Brooklyn, NY 11219 | 2020-09-04 |
| 1164033643 | Debbie Evadne Evans-wright | Nurse Practitioner | 979 48th Street, Brooklyn, NY 11219 | 2020-08-10 |
| 1528614559 | Jonathan Benjamin Goldstein | Specialist | Yeled Vyalda 1312 38 Street, Brooklyn, NY 11219 | 2019-08-15 |
| 1235782301 | Vanessa Walton | Social Worker | 4012 New Utrecht Avenue, Apt 1, Brooklyn, NY 11219 | 2019-07-18 |
| 1083184618 | Sandra Murray | Licensed Practical Nurse | 6321 New Utrecht Avenue Second Floor, Brooklyn, NY 11219 | 2018-11-27 |
| 1023588746 | Wanipa Muwowo-nwade | Physician Assistant | 4802 10th Ave Rm 301, Brooklyn, NY 11219 | 2018-11-26 |
| 1366919896 | Evelin Ponce | Licensed Practical Nurse | 6321 New Utrecht Avenue, Second Floor, Brooklyn, NY 11219 | 2018-11-02 |
| 1083180301 | Yefim Simkhayev | Occupational Therapist | 1317 52nd St, Brooklyn, NY 11219 | 2018-10-15 |
| 1598240186 | F & D Pharmacy Inc | Pharmacy | 5504 -13 Ave, Brooklyn, NY 11219 | 2018-09-28 |
| 1245737469 | Yekaterina Joltikov | Student in an Organized Health Care Education/Training Program | Miamonides Medical Center, 4802 10th Ave, Brooklyn, NY 11219 | 2018-04-13 |
| Find all providers in zip 11219 | ||||
| Taxonomy Code | 2080N0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neonatal-Perinatal Medicine |
| A pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093238339 | Maria Pygerou-kofinas | Pediatrics | 506 Sixth Street Kp4, Brooklyn, NY 11215 | 2017-07-19 |
| 1063893089 | Namirembe Joan Kazibwe | Pediatrics | 539, 85th Street, Apt 3f, Brooklyn, NY 11209 | 2015-06-16 |
| 1114339322 | Michelle Quan | Pediatrics | 388 Bridge St, Apt 11b, Brooklyn, NY 11201-5210 | 2014-05-21 |
| 1952728883 | Thomas Hays | Pediatrics | 41 Hausman St, Brooklyn, NY 11222 | 2014-03-28 |
| 1992885057 | Ali Nadroo | Pediatrics | 236 7th Ave, Brooklyn, NY 11215-3415 | 2006-10-16 |
| 1265523427 | Gratias Tom Mundakel | Pediatrics | 451 Clarkson Ave, C4128, Kings County Hospital Center, Brooklyn, NY 10301 | 2006-09-27 |
| 1194789388 | Asma Asif Ahmad | Pediatrics | 461 Clarkson Ave, Kings County Medical Center, Brooklyn, NY 11203 | 2006-04-14 |
| 1528063377 | John Casey | Pediatrics | 760 Broadway, Woodhull Medical & Mental Health Center, Department of Pediatrics, Brooklyn, NY 11206 | 2005-06-17 |
| 1427445949 | Anna Zylak | Pediatrics | 121 Dekalb Ave, Dept of Pediatrics, The Brooklyn Hospital Center, Brooklyn, NY 11201 | 2015-04-22 |
| 1275960742 | Chris Papazafiratou | Pediatrics | 2601 Ocean Parkway, Brooklyn, NY 11235 | 2013-09-30 |
| Find all providers in BROOKLYN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.