Provider Demographics
NPI:1841270741
Name:GARG, RAKESH K (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:K
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:179 HIGH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-1010
Practice Address - Country:US
Practice Address - Phone:973-579-3444
Practice Address - Fax:973-522-5121
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03762200207R00000X, 207RP1001X
NJMA37622207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3808106Medicaid
NJ3808106Medicaid
NJD19128Medicare UPIN
NJ457777N1WMedicare ID - Type Unspecified