Provider Demographics
NPI:1548404254
Name:AGGARWAL, SURABHI (MD)
Entity Type:Individual
Prefix:
First Name:SURABHI
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:631-444-2710
Mailing Address - Fax:631-444-7865
Practice Address - Street 1:STONY BROOK UNIVERSITY HOSPITAL
Practice Address - Street 2:MEDICAL STAFF OFFICE T14
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-7148
Practice Address - Country:US
Practice Address - Phone:631-444-2754
Practice Address - Fax:631-444-6031
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2019-12-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY301904-012080N0001X, 2080N0001X
HI165712080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine