Provider Demographics
NPI:1508207069
Name:AGGARWAL, DEEPAK (PT)
Entity Type:Individual
Prefix:
First Name:DEEPAK
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 OLD SPRINGVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:AL
Mailing Address - Zip Code:35215-5858
Mailing Address - Country:US
Mailing Address - Phone:800-854-4589
Mailing Address - Fax:205-520-0455
Practice Address - Street 1:1920 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:CENTER POINT
Practice Address - State:AL
Practice Address - Zip Code:35215-5858
Practice Address - Country:US
Practice Address - Phone:800-854-4589
Practice Address - Fax:205-520-0455
Is Sole Proprietor?:No
Enumeration Date:2013-07-12
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA01480600225100000X
DEJ1-0003275225100000X
MD24333225100000X
NY035888225100000X
PAPT024300225100000X
VA2305208371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist