Provider Demographics
NPI:1023075363
Name:AGGARWAL, VINOD K (MD FCCP)
Entity type:Individual
Prefix:
First Name:VINOD
Middle Name:K
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:MD FCCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WICKATUNK
Mailing Address - State:NJ
Mailing Address - Zip Code:07765
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:702 NORTH BEERS STREET
Practice Address - Street 2:STE 2
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733
Practice Address - Country:US
Practice Address - Phone:732-718-0663
Practice Address - Fax:732-264-8858
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA55517207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
425679Medicare ID - Type Unspecified
G04360Medicare UPIN