Healthcare Provider Details

I. General information

NPI: 1871518050
Provider Name (Legal Business Name): SUNIL DUTT AGGARWAL M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 NORTH VILLAGE AVE MERCY MEDICAL CENTER
ROCKVILLE CENTER NY
11570
US

IV. Provider business mailing address

190 CEDAR SHORE DR
MASSAPEQUA NY
11758-8140
US

V. Phone/Fax

Practice location:
  • Phone: 516-705-2854
  • Fax: 516-705-2011
Mailing address:
  • Phone: 516-797-4320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number233883
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: