Provider Demographics
NPI:1205802592
Name:PAL, ARUNA (MD)
Entity type:Individual
Prefix:DR
First Name:ARUNA
Middle Name:
Last Name:PAL
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 1:301 PROSPECT AVE
Mailing Address - Street 2:CPEP
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-726-8610
Mailing Address - Fax:315-726-8671
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:CPEP
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-726-8610
Practice Address - Fax:315-726-8671
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202308-12084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01683563Medicaid
NY48M251Medicare ID - Type Unspecified
NY01683563Medicaid
GS7478Medicare UPIN