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General NPI Number Information
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NPI Number | 1386205458
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Entity Type | Individual
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Provider Name | RIA GARG MD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 09/20/2023
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Provider Practice Location Address
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Address Line | 22201 MOROSS RD STE 80
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City | DETROIT
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State | MI
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Zip | 48236-2169
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Country | US
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Telephone | 343-313-3800
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Fax | 313-343-4756
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Provider Business Mailing Address
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Address Line | 725 IRVING AVE SUITE 112
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City | SYRACUSE
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State | NY
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Zip | 13210-2306
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Country | US
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Telephone | 315-646-6395
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Fax | 315-464-6322
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 325245
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License Number State | NY
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