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Kevin Modera
Student in an Organized Health Care Education/Training Program in Bridgeport, Connecticut
NPI 1649963505

Kevin Modera is a Student in an Organized Health Care Education/Training Program based in Bridgeport, CT. Kevin Modera practices in Bridgeport, CT. The NPI Number for Kevin Modera is 1649963505 and holds a License No. (Connecticut).

The current practice location address for Kevin Modera is 3741 Main St, Bridgeport, CT and can be reached out via phone at 510-908-3718.

Location: 3741 Main St, Bridgeport, CT, 06606-3609
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1649963505
Provider Name
Kevin Modera
Credential
Provider Entity Type
Individual
Gender
Male
Address
3741 Main St, Bridgeport, CT, 06606-3609
Phone Number
510-908-3718
Fax Number
Provider Enumeration Date
05/29/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
3741 Main St
City
Bridgeport
State
Connecticut
Zip
06606-3609
Phone Number
510-908-3718
Fax Number
person
Provider Business Mailing Address Details
Address
3741 Main St
City
Bridgeport
State
Connecticut
Zip
06606-3609
Phone Number
510-908-3718
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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