Individual provider · Type 1 NPI

Kishan Modessa

Student in an Organized Health Care Education/Training Program · Allentown, PA

NPI number 1972174811 Active

Practice location

4123 Emerson Ln
Allentown, PA 18104-3448

Call (484) 868-8977 Map

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1972174811

Kishan Modessa's National Provider Identifier is 1972174811, issued on Jul 1, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Allentown, PA. The record was last updated on Jul 1, 2021.