Healthcare Provider Details

I. General information

NPI: 1710760855
Provider Name (Legal Business Name): MODANI CARE MI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1149 STATE ROUTE 17M
CHESTER NY
10918-1432
US

IV. Provider business mailing address

254 NININGER RD STE 401
MONROE NY
10950-4276
US

V. Phone/Fax

Practice location:
  • Phone: 212-402-1061
  • Fax:
Mailing address:
  • Phone: 212-402-1061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: JOEL KRAUSZ
Title or Position: CEO
Credential:
Phone: 212-402-1061