Provider Demographics
NPI:1710973847
Name:GARG, INDU (MD)
Entity Type:Individual
Prefix:
First Name:INDU
Middle Name:
Last Name:GARG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 QUAIL RUN
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1044
Mailing Address - Country:US
Mailing Address - Phone:415-515-9800
Mailing Address - Fax:718-231-7942
Practice Address - Street 1:2705 WILLIAMSBRIDGE RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-4109
Practice Address - Country:US
Practice Address - Phone:718-515-9800
Practice Address - Fax:718-231-7942
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1724459208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01059136Medicaid
NY01059136Medicaid
24E421Medicare ID - Type Unspecified