Provider Demographics
NPI:1558746040
Name:VAGRECHA, ANSHUL KAMLESH (MBBS)
Entity Type:Individual
Prefix:DR
First Name:ANSHUL
Middle Name:KAMLESH
Last Name:VAGRECHA
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:ANSHUL
Other - Middle Name:KAMLESH
Other - Last Name:VAGHRECHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:26901 76TH AVE STE 255
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1433
Mailing Address - Country:US
Mailing Address - Phone:716-470-3460
Mailing Address - Fax:718-343-4642
Practice Address - Street 1:26901 76TH AVE STE 255
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1433
Practice Address - Country:US
Practice Address - Phone:716-470-3460
Practice Address - Fax:718-343-4642
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-24
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY2945882080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-OncologyGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty