Provider Demographics
NPI:1801057054
Name:GRESENS, ANJALI ARORA (MD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:ARORA
Last Name:GRESENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ANJALI
Other - Middle Name:SHIVANI
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6333 CENTER DR BLDG 16
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-4126
Mailing Address - Country:US
Mailing Address - Phone:757-252-9500
Mailing Address - Fax:757-962-9801
Practice Address - Street 1:6333 CENTER DR BLDG 16
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-4126
Practice Address - Country:US
Practice Address - Phone:757-252-9500
Practice Address - Fax:757-962-9801
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116020392390200000X
VA0101255762208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program