Provider Demographics
NPI:1760475800
Name:AGGARWAL, SAROJ (MD)
Entity Type:Individual
Prefix:
First Name:SAROJ
Middle Name:
Last Name:AGGARWAL
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 1:12000 MCCRACKEN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GARFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44125-2964
Mailing Address - Country:US
Mailing Address - Phone:216-581-0470
Mailing Address - Fax:216-581-0474
Practice Address - Street 1:12000 MCCRACKEN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GARFIELD HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2964
Practice Address - Country:US
Practice Address - Phone:216-581-0470
Practice Address - Fax:216-581-0474
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-029663A207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
34-1352147OtherTAX IDENTIFICATION
OH000000333444OtherANTHEM ID#
OH0053454Medicaid
34-1352147OtherTAX IDENTIFICATION
OHA14669Medicare UPIN