Provider Demographics
NPI:1114191434
Name:VINOD K. AGGARWAL, M.D., P.C.
Entity Type:Organization
Organization Name:VINOD K. AGGARWAL, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VINOD
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGGARWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-264-7755
Mailing Address - Street 1:PO BOX 229
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765-0229
Mailing Address - Country:US
Mailing Address - Phone:732-264-7755
Mailing Address - Fax:
Practice Address - Street 1:721 N BEERS ST
Practice Address - Street 2:SUITE 2G & SUITE 2H
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1518
Practice Address - Country:US
Practice Address - Phone:732-264-7755
Practice Address - Fax:732-264-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-17
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7118902Medicaid
NJ425679Medicare PIN