Healthcare Provider Details

I. General information

NPI: 1841631520
Provider Name (Legal Business Name): DEEPIKA GARG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2013
Last Update Date: 09/22/2021
Certification Date: 09/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 HOLLY HILL LN STE 270
GREENWICH CT
06830-6074
US

IV. Provider business mailing address

55 HOLLY HILL LN STE 270
GREENWICH CT
06830-6074
US

V. Phone/Fax

Practice location:
  • Phone: 203-863-2990
  • Fax:
Mailing address:
  • Phone: 203-863-2990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number006545
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number10752532-1205
License Number StateUT
# 3
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number69121
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: