MISS Lisa Maria Modesto, O.D.

NPI #1598879637 in Forest Hills, New York

Provider Information

NPI Number: 1598879637
Entity Type: Individual
Name: MISS Lisa Maria Modesto, O.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Optometrist
Credential: O.D.
Enumeration Date: Aug 18, 2006
Last Updated: Feb 27, 2008

Practice Location

Address: 10933 71ST RD
Address 2: SUITE 2 C
City: Forest Hills
State: New York
ZIP Code: 11375-4867
Phone: (718) 261-3366

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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