Healthcare Provider Details

I. General information

NPI: 1821340290
Provider Name (Legal Business Name): RAJESH AGGARWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2012
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST 4 SILVERSTEIN
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

211 S 9TH ST STE 402
PHILADELPHIA PA
19107-6810
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-2626
  • Fax:
Mailing address:
  • Phone: 215-955-0020
  • Fax: 215-503-7577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD446575
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: