Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MA55517 | NJ |
NPI | 1023075363 |
---|---|
Provider Name | Vinod K Aggarwal |
First Address | Wickatunk, NJ 07765 |
Second Address | Holmdel, NJ 07733 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G04360 | (02) |