Provider Demographics
NPI:1467419291
Name:AGARWALA, NEENA (MD)
Entity Type:Individual
Prefix:DR
First Name:NEENA
Middle Name:
Last Name:AGARWALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 E 57TH ST STE 1F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2945
Mailing Address - Country:US
Mailing Address - Phone:646-858-1811
Mailing Address - Fax:646-756-4171
Practice Address - Street 1:335 E 57TH ST STE 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2945
Practice Address - Country:US
Practice Address - Phone:646-858-1811
Practice Address - Fax:646-756-4171
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262473207VG0400X, 207VF0040X, 207V00000X
NE22269207V00000X
PAMD071087L207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47078557540Medicaid
NEH27470Medicare UPIN
NE275822Medicare ID - Type Unspecified
NE47078557540Medicaid