Healthcare Provider Details

I. General information

NPI: 1912973140
Provider Name (Legal Business Name): NARAYAN DAS AGRAWAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 72ND ST
JACKSON HEIGHTS NY
11372-6126
US

IV. Provider business mailing address

PO BOX 670700
FLUSHING NY
11367-0700
US

V. Phone/Fax

Practice location:
  • Phone: 718-205-2785
  • Fax: 718-424-3436
Mailing address:
  • Phone: 718-205-2785
  • Fax: 718-424-3436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number225128
License Number StateNY

VIII. Authorized Official

Name: DR. NARAYAN DAS AGRAWAL
Title or Position: SOLE PROPRIETER
Credential:
Phone: 718-205-2785