Healthcare Provider Details

I. General information

NPI: 1902031917
Provider Name (Legal Business Name): SEEMA AGARWAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2009
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WATERS PL STE M101
BRONX NY
10461-2729
US

IV. Provider business mailing address

1250 WATERS PL SUITE 506
BRONX NY
10461-2720
US

V. Phone/Fax

Practice location:
  • Phone: 718-892-1200
  • Fax: 718-918-1696
Mailing address:
  • Phone: 718-892-1200
  • Fax: 718-918-1696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number253185
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number253185
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: