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General NPI Number Information
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NPI Number | 1922252733
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Entity Type | Organization
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Legal Business Name | SAUL M. MODLIN M.D., P.C.
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Dates
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Enumeration Date | 11/06/2008
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 300 GARDEN CITY PLZ SUITE 248
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City | GARDEN CITY
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State | NY
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Zip | 11530-3302
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Country | US
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Telephone | 631-737-4168
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Fax | 631-737-2180
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Provider Business Mailing Address
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Address Line | 300 GARDEN CITY PLZ SUITE 248
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City | GARDEN CITY
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State | NY
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Zip | 11530-3302
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Country | US
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Telephone | 631-737-4168
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Fax | 631-737-2180
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MR. UELI PIO LAENG
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Credential |
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Telephone | 631-737-4168
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | F38829
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License Number State | NY
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