MARA C MODZESKI


Address: 132 Abigail Ln, Port Matilda, PA 16870-7153
Phone: 8142725011

MARA C MODZESKI (NPI# 1053758094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1053758094
Entity Type Individual
Full Name MARA C MODZESKI
Credential MD
Practice Address 132 Abigail Ln
Port Matilda
PA 16870-7153
Mailing Address 100 N Academy Ave
Danville
PA 17822-4903
Practice Telephone 8142725011
Practice Fax Number 8142726531
Mailing Telephone 5702716144
Enumeration Date 2013-05-31
Last Update Date 2020-09-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Y00000X Otolaryngology MD464929 PA Allopathic & Osteopathic Physicians
N 207Y00000X Otolaryngology 58125 MN Allopathic & Osteopathic Physicians

Office Location

Street Address 132 ABIGAIL LN
City PORT MATILDA
State PA
Zip Code 16870-7153

Providers in the same location

NPI Name Taxonomy Address Enumeration
1124019104 Michael G Lesko Internal Medicine 132 Abigail Ln, Port Matilda, PA 16870-7153 2005-10-31
1609486596 Jacob Mills Psychologist 132 Abigail Ln, Port Matilda, PA 16870-7153 2020-08-05
1912522590 Ashley Megan Enciso Nurse Practitioner 132 Abigail Ln, Port Matilda, PA 16870-7153 2020-06-10
1275099103 Kathryn R Hundley Specialist/Technologist 132 Abigail Ln, Port Matilda, PA 16870-7153 2019-02-15
1164913380 Jacqueline Leigh Kline Registered Nurse 132 Abigail Ln, Port Matilda, PA 16870-7153 2018-05-23
1306335211 Mary Jane Rocco Registered Nurse 132 Abigail Ln, Port Matilda, PA 16870-7153 2018-05-07
1023556677 Shahida Fareed Psychologist 132 Abigail Ln, Port Matilda, PA 16870 2017-02-03
1922554518 Alyssa Sebastianelli Nurse Practitioner 132 Abigail Ln, Port Matilda, PA 16870-5700 2016-09-01
1427407220 Haley Bridges Physician Assistant 132 Abigail Ln, Port Matilda, PA 16870-7153 2016-06-13
1417323031 Anne Sommerfeld Clause Physician Assistant 132 Abigail Ln, Port Matilda, PA 16870 2015-08-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1063732717 St. Joseph Institute Substance Abuse Rehabilitation Facility 134 Jacobs Way, Port Matilda, PA 16870 2010-06-04
1548444268 Georgianna M Achilles Psychologist 454 Rolling Ridge Dr., Port Matilda, PA 16870 2007-12-18
1497803605 Paul Hughes Dentist 101 Briar Court, Port Matilda, PA 16870 2007-01-08
1992896237 Patrick A. Jarvie Pediatrics Geisinger Pediatrics, 132 Abigail Lane, Port Matilda, PA 16870 2006-09-28
1316948011 Port Matilda Emergency Medical Services Ambulance 402 S High St, Port Matilda, PA 16870 2005-08-03
1366934101 Karen Marie Brooks Registered Nurse 132 Abigail Lane, Port Matilda, PA 16870 2018-06-06
1326410622 Nickol Marie Cleary Physical Therapist 785 E Mountain Rd, Port Matilda, PA 16870 2015-10-26
1306125190 Hithem Rahmi Orthopaedic Surgery 132 Abigail Lane, Port Matilda, PA 16870 2011-08-10
1336441039 Universal Community Behavioral Health Inc Clinic/Center 132 Abigail Lane, Port Matilda, PA 16870 2010-12-01
1083874770 Geisinger Clinic Nurse Practitioner 132 Abigail Lane, Port Matilda, PA 16870 2008-06-16
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Taxonomy Information

Taxonomy Code 207Y00000X
Grouping Allopathic & Osteopathic Physicians
Classification Otolaryngology

Taxonomy Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1154595619 Evan James Harlor Otolaryngology 132 Abigail Ln, Port Matilda, PA 16870-7153 2008-04-16
1801802061 Henry Cramer Otolaryngology 132 Abigail Lane, Port Matilda, PA 16870-5700 2006-07-31

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1043877319 Health Services of Clarion, Inc. Otolaryngology 30 Pinnacle Dr Ste 301, Clarion, PA 16214-3800 2019-05-22
1134680747 Providence Ear Nose & Throat Associates Inc Otolaryngology Riddle Mem. Hosp.- Outpt. Pav., 1098 W. Baltimore Pk. Ste 3406, Media, PA 19063-5139 2019-03-27
1619437654 Providence Ear Nose & Throat Associates Inc Otolaryngology 500 Evergreen Dr Ste 18, Glen Mills, PA 19342-1032 2019-03-25
1659844264 David C Hughes Otolaryngology 1047 Lilac St, Indiana, PA 15701-2459 2019-01-07
1790278372 Vishaal Patel Otolaryngology 3440 N Broad St # 300, Philadelphia, PA 19140-5104 2018-06-08
1710409594 Philippe Lavigne Otolaryngology 200 Lothrop St Ste 300, Pittsburgh, PA 15213-2536 2017-07-12
1033630892 Jessica Anne Tang Otolaryngology 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 2017-07-03
1417313255 Robert Guelcher Otolaryngology 521 Montmarc Blvd, Erie, PA 16504-2611 2016-01-09
1689057804 Rui Jun Lin Otolaryngology 2533b Wharton St, Pittsburgh, PA 15203-5103 2015-07-07
1861870511 Giuseppe V Staltari Otolaryngology 203 Lothrup Street, Eye and Ear Building, Suite 500, Pittsburgh, PA 15213-2536 2015-05-14
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Competitor

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City PORT MATILDA
Zip Code 16870

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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