Provider Demographics
NPI:1609067065
Name:MEDICHECK GROUP INC.,
Entity Type:Organization
Organization Name:MEDICHECK GROUP INC.,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ATUL
Authorized Official - Middle Name:K
Authorized Official - Last Name:AGARWALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:212-795-4544
Mailing Address - Street 1:1602 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-3311
Mailing Address - Country:US
Mailing Address - Phone:212-795-4544
Mailing Address - Fax:
Practice Address - Street 1:1602 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10040-3311
Practice Address - Country:US
Practice Address - Phone:212-795-4544
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA61586207W00000X
NY207R00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1900871OtherNY LICENSE
10456275OtherCAQH
NJMA-06158600OtherNJ LICENSE
NY01446428Medicaid
1427133586OtherNPI
NJ6875700OtherNJ MEDICAID
NJ792642OtherNJ MEDICARE
1427133586OtherNPI
NY1900871OtherNY LICENSE