MEDICARE: NIYATI MODI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	054201	NY

General Provider Information

NPI Number	:	1134010465
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIYATI MODI

Provider Business Mailing Address
First Line	:	280 W 231ST ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10463-3940
Country	:	US
Telephone Number	:	718-514-6120
Fax Number	:

Provider Business Practice Location Address
First Line	:	255 E 138TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10451-6425
Country	:	US
Telephone Number	:	718-559-0909
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2025
Last Update Date	:	07/14/2025

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Directions to “ NIYATI MODI ” Practice Location

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