Dominique Gomez Modesto, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00964000 Issued in NJ

Practice address

2 Stone Harbor Blvd
Cape May Court House, NJ 08210-2138

Phone

(609) 463-2000

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891817367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 CHURCHILL DR",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082348002",
            "telephone_number": "609-653-2798",
            "fax_number": "609-653-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 STONE HARBOR BLVD",
            "city": "CAPE MAY COURT HOUSE",
            "state": "NJ",
            "postal_code": "082102138",
            "telephone_number": "609-463-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODESTO",
        "first_name": "DOMINIQUE",
        "middle_name": "GOMEZ",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00964000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher W Miller, MASTER OF SOCIOLOGY
• Lori Miller
• Marta Miller, LPN
• Jessica Mingoia, OTR/L
• Gary S Mirone, DO
• Modra Health LLC
• Nadezda Molodykh, APN
• Rosemary Montgomery
• Lovella Callanga More, P.T.
• Taylor Shea Morgan, COTA/L

• Physical Therapist in Cape May Court House, NJ
• Providers in Cape May Court House, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.