Provider Demographics
NPI:1437771433
Name:AGARWAL, LIPISHA SUSHIL (MBBS)
Entity Type:Individual
Prefix:
First Name:LIPISHA
Middle Name:SUSHIL
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MT AUBURN ST MOUNT AUBURN HOSPITAL
Mailing Address - Street 2:DEPT OF MEDICINE
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138
Mailing Address - Country:US
Mailing Address - Phone:617-499-5571
Mailing Address - Fax:
Practice Address - Street 1:330 MT AUBURN ST
Practice Address - Street 2:INTERNAL MEDICINE RESIDENCY PROGRAM MOUNT AUBURN HOSPIT
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138
Practice Address - Country:US
Practice Address - Phone:617-499-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-12
Last Update Date:2022-03-01
Deactivation Date:2022-01-11
Deactivation Code:
Reactivation Date:2022-03-01
Provider Licenses
StateLicense IDTaxonomies
MA285481207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program