Provider Demographics
NPI:1689655581
Name:AGGARWAL, AVINASH
Entity Type:Individual
Prefix:
First Name:AVINASH
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2865 FREEPORT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NATRONA HTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:532 S AIKEN AVE STE 300
Practice Address - Street 2:SUITE 300
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1521
Practice Address - Country:US
Practice Address - Phone:412-681-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050327L2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015122190008Medicaid
G02088Medicare UPIN
PA633300Medicare ID - Type Unspecified