Healthcare Provider Details

I. General information

NPI: 1164881900
Provider Name (Legal Business Name): NEENA AGARWALA, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2016
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

335 E 57TH ST
NEW YORK NY
10022-2945
US

IV. Provider business mailing address

335 E 57TH ST RM 1F
NEW YORK NY
10022-2945
US

V. Phone/Fax

Practice location:
  • Phone: 646-858-1811
  • Fax: 646-756-4171
Mailing address:
  • Phone: 646-858-1811
  • Fax: 646-756-4171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number262473
License Number StateNY

VIII. Authorized Official

Name: DR. NEENA AGARWALA
Title or Position: PRESIDENT
Credential: MD
Phone: 212-557-4646