KUMKUM S MODWEL MD LLC NPI 1770905754

NPI Information

NPI: 1770905754
Provider Name: KUMKUM S MODWEL MD LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 07D2072575

Address:
153 S MAIN ST
NEWTOWN, CT
ZIP 06470
Phone: (203) 270-1077
Get Directions

KUMKUM S MODWEL MD LLC is a family medicine in Newtown, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KUMKUM S MODWEL MD LLC NPI is 1770905754. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

153 S MAIN ST
NEWTOWN, CT
ZIP 06470-791
Phone: (203) 270-1077
Fax: (203) 270-0420

The provider's authorized official is Kumkum S Modwel .
The authorized official title is Owner and has the following contact phone number (203) 270-7592.

The CLIA number assigned to this NPI record is 07D2072575 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/10/2014 and was last updated on 1/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine			CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D400070046	MEDICARE UPIN	CONNECTICUT
2	001392563	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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