| Kumkum S Modwel Md Llc | |
|
153 S Main St Newtown CT 06470-2791 | |
| (203) 270-1077 | |
| (203) 270-0420 |
| Full Name | Kumkum S Modwel Md Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 153 S Main St, Newtown, Connecticut |
| Authorized Official Name and Position | Kumkum S Modwel (OWNER) |
| Authorized Official Contact | 2032707592 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kumkum S Modwel Md Llc 153 S Main St Newtown CT 06470-2791 Ph: (203) 270-1077 | Kumkum S Modwel Md Llc 153 S Main St Newtown CT 06470-2791 Ph: (203) 270-1077 |
| NPI Number | 1770905754 |
|---|---|
| Provider Enumeration Date | 01/10/2014 |
| Last Update Date | 01/10/2014 |
| Medicare PECOS PAC ID | 7416170774 |
|---|---|
| Medicare Enrollment ID | O20140514001429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770905754 | NPI | - | NPPES |
| 001392563 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Connecticut) | Primary |
| Provider Name | Kumkum S Modwel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720011943 PECOS PAC ID: 0244130078 Enrollment ID: I20040109000426 |
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