Provider Demographics
NPI:1275638520
Name:GARG, DHARAM PAUL
Entity Type:Individual
Prefix:
First Name:DHARAM
Middle Name:PAUL
Last Name:GARG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3218 WALDEN AVE
Mailing Address - Street 2:
Mailing Address - City:DEPEW
Mailing Address - State:NY
Mailing Address - Zip Code:14043-2878
Mailing Address - Country:US
Mailing Address - Phone:716-684-3500
Mailing Address - Fax:716-684-9690
Practice Address - Street 1:3218 WALDEN AVE
Practice Address - Street 2:
Practice Address - City:DEPEW
Practice Address - State:NY
Practice Address - Zip Code:14043-2878
Practice Address - Country:US
Practice Address - Phone:716-684-3500
Practice Address - Fax:716-684-9690
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1579141282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access