Provider Demographics
NPI:1093244378
Name:AGGARWAL, RAGHAV (MD)
Entity Type:Individual
Prefix:
First Name:RAGHAV
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:32 STRAWBERRY HILL CT
Mailing Address - Street 2:4TH FL, STE 6
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-2594
Mailing Address - Country:US
Mailing Address - Phone:203-977-2566
Mailing Address - Fax:203-977-2568
Practice Address - Street 1:32 STRAWBERRY HILL CT
Practice Address - Street 2:4TH FL, STE 6
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2594
Practice Address - Country:US
Practice Address - Phone:203-977-2566
Practice Address - Fax:203-977-2568
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT066279207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program