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NPI 1215851092

NPI 1215851092 : AVIATOR CARE PENNSYLVANIA, P.C. : KING OF PRUSSIA, PA

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General NPI Number Information
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    NPI Number           |    1215851092
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    Entity Type          |    Organization 
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    Legal Business Name  |    AVIATOR CARE PENNSYLVANIA, P.C. 
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Dates
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    Enumeration Date     |    08/05/2026
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    Last Update Date     |    08/05/2026
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Provider Practice Location Address
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    Address Line         |    1004 W 8TH AVE STE F 
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    City                 |    KING OF PRUSSIA
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    State                |    PA
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    Zip                  |    19406-1344
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    Country              |    US
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    Telephone            |    708-571-0279
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    169 MADISON AVE STE 78180 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10016-5101
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    Country              |    US
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    Telephone            |    708-571-0279
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PRESIDENT
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    Name                 |     FARHAD  MODARAI 
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    Credential           |    DO
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    Telephone            |    856-524-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    
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    License Number State |    
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