Provider Demographics
NPI:1720378284
Name:ARUN K AGRAWAL,MD.PC
Entity Type:Organization
Organization Name:ARUN K AGRAWAL,MD.PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUN
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:AGRAWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-565-4789
Mailing Address - Street 1:33 FRONT ST
Mailing Address - Street 2:303
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3601
Mailing Address - Country:US
Mailing Address - Phone:516-565-4789
Mailing Address - Fax:516-565-4036
Practice Address - Street 1:33 FRONT ST
Practice Address - Street 2:303
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3601
Practice Address - Country:US
Practice Address - Phone:516-565-4789
Practice Address - Fax:516-565-4036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-18
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY159622207L00000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty