Provider Demographics
NPI:1992676852
Name:MODANI CARE ID LLC
Entity type:Organization
Organization Name:MODANI CARE ID LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAUSZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-402-1062
Mailing Address - Street 1:254 NININGER RD STE 303
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NEW YORK
Mailing Address - Zip Code:10950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:254 NININGER RD STE 303
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NEW YORK
Practice Address - Zip Code:10950
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty