Provider Demographics
NPI:1568523496
Name:AGRAWAL, VIKAS KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:VIKAS
Middle Name:KUMAR
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVE APT 16H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7666
Mailing Address - Country:US
Mailing Address - Phone:646-764-8183
Mailing Address - Fax:
Practice Address - Street 1:1650 GRAND CONCOURSE
Practice Address - Street 2:DEPARTMENT OF MEDICINE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7606
Practice Address - Country:US
Practice Address - Phone:718-960-1032
Practice Address - Fax:718-960-2055
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2731402084N0400X
FLME821742084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology