Provider Demographics
NPI:1639924525
Name:ARYAL, LAXMI (MD)
Entity type:Individual
Prefix:MRS
First Name:LAXMI
Middle Name:
Last Name:ARYAL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 BROADWAY WOODHULL HOSPITAL
Mailing Address - Street 2:PEDIATRIC ADMINISTRATION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8779
Mailing Address - Fax:718-963-7957
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:PEDIATRIC ADMINISTRATION
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8779
Practice Address - Fax:718-963-7957
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2025-03-19
Deactivation Date:2024-12-23
Deactivation Code:
Reactivation Date:2025-03-19
Provider Licenses
StateLicense IDTaxonomies
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program