Provider Demographics
NPI:1295997377
Name:AGGARWAL, PUJA (MD)
Entity type:Individual
Prefix:
First Name:PUJA
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 1:555 W STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5119
Mailing Address - Country:US
Mailing Address - Phone:412-367-1000
Mailing Address - Fax:407-767-1200
Practice Address - Street 1:9104 BABCOCK BLVD
Practice Address - Street 2:SUITE 2116
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-5818
Practice Address - Country:US
Practice Address - Phone:412-367-1000
Practice Address - Fax:412-367-2725
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4521242084N0400X
MDD00743502084N0400X
DCMD0408122084N0400X
390200000X
FLME1300622084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ145105Medicaid
WVWVE925J659Medicaid