Healthcare Provider Details

I. General information

NPI: 1992806400
Provider Name (Legal Business Name): NEENA AGGARWAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 FRANKLIN AVE MLKJR HEALTH CENTER, 3RD FLOOR, PEDIATRICS
BRONX NY
10456-3501
US

IV. Provider business mailing address

1265 FRANKLIN AVE MLKJR HEALTH CENTER, 3RD FLOOR, PEDIATRICS
BRONX NY
10456-3501
US

V. Phone/Fax

Practice location:
  • Phone: 718-503-7700
  • Fax: 718-503-7741
Mailing address:
  • Phone: 718-503-7700
  • Fax: 718-503-7712

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number147333
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: