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Mr. Edward J Modica, ATC,EMT-B
Specialist in Massapequa, New York
NPI 1821312331

Edward J Modica is a Specialist based in Massapequa, NY. Edward J Modica practices in Massapequa, NY and has the professional credentials of ATC,EMT-B. The NPI Number for Edward J Modica is 1821312331 and holds a License No. 000370-1 (New York).

The current practice location address for Edward J Modica is 434 N Bleecker Dr, Massapequa, NY and can be reached out via phone at 516-721-6541.

Location: 434 N Bleecker Dr, Massapequa, NY, 11758-1340
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821312331
Provider Name
Edward J Modica
Credential
ATC,EMT-B
Provider Entity Type
Individual
Gender
Male
Address
434 N Bleecker Dr, Massapequa, NY, 11758-1340
Phone Number
516-721-6541
Fax Number
Provider Enumeration Date
03/26/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000370-1 01 NY NY STATE LICENSE
institution
Provider Business Practice Location Address Details
Address
434 N Bleecker Dr
City
Massapequa
State
New York
Zip
11758-1340
Phone Number
516-721-6541
Fax Number
person
Provider Business Mailing Address Details
Address
434 N Bleecker Dr
City
Massapequa
State
New York
Zip
11758-1340
Phone Number
516-721-6541
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
000370-1 (New York)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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