Healthcare Provider Details

I. General information

NPI: 1497993984
Provider Name (Legal Business Name): SHRINKHLA AGRAWAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHRINKHLA AGRAWAL MD

II. Dates (important events)

Enumeration Date: 01/22/2009
Last Update Date: 07/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 FULTON ST
BROOKLYN NY
11216-2505
US

IV. Provider business mailing address

526 MACDONOUGH ST APT 2
BROOKLYN NY
11233
US

V. Phone/Fax

Practice location:
  • Phone: 718-636-4500
  • Fax:
Mailing address:
  • Phone: 610-800-1255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number272359
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01066450A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: