1992776264 NPI number — DR. ARVIND K AGARWAL MD

Table of content: DR. ARVIND K AGARWAL MD (NPI 1992776264)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992776264 NPI number — DR. ARVIND K AGARWAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AGARWAL
Provider First Name:
ARVIND
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1992776264
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 GRAND STREET, 3RD FL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10901-1035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-942-1001
Provider Business Mailing Address Fax Number:
845-987-5979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 LIBERTY SQUARE MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STONY POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10980-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-942-1001
Provider Business Practice Location Address Fax Number:
845-942-1431
Provider Enumeration Date:
01/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X , with the licence number:  25MA05466900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000011011 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0176839 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110034987 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4123842 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0056891 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 111011 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 62F991 . This is a "EMPIRE BC STONY POINT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 700955 . This is a "US FAMILY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01230928 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133693126 . This is a "TAX ID #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 717024 . This is a "MVP/TACONIC IPA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N31516 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0525006 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 181950 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 62F992 . This is a "EMPIRE BC WEST NYACK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: RS093 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 001702 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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