Healthcare Provider Details

I. General information

NPI: 1003471897
Provider Name (Legal Business Name): ANISHA GARG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 UNION SQ E
NEW YORK NY
10003-3314
US

IV. Provider business mailing address

4391 NEWTON CIR
EMMAUS PA
18049-1258
US

V. Phone/Fax

Practice location:
  • Phone: 212-420-2000
  • Fax:
Mailing address:
  • Phone: 484-225-6968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License Number330341
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: