MS. COLETTE JOHANNA MODRAK AGPCNP NPI 1407666761

NPI Information

  • NPI: 1407666761
  • Provider Name: MS. COLETTE JOHANNA MODRAK, AGPCNP
  • Classification: Nurse Practitioner - 363LA2200X
  • Specialization: Adult Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2365 S CLINTON AVE
    ROCHESTER, NY
    ZIP 14618
  • Phone: (585) 613-5840

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NPI Details

MS. Colette Johanna Modrak, AGPCNP is an adult health nurse practitioner in Rochester, NY with 2 years of experience. MS. Colette Johanna Modrak, AGPCNP NPI is 1407666761. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2365 S CLINTON AVE
ROCHESTER, NY
ZIP 14618-663
Phone: (585) 613-5840

The NPI 1407666761 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/9/2025 and was last updated on 1/9/2025.

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
1363LA2200XNurse PractitionerAdult Health311817NEW YORKYes

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: 11/21/2025

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