Basic Information
| Provider Information | |||||||||
| NPI: | 1427041987 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | AGGARWAL | ||||||||
| FirstName: | ALKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068106099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037396959 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 24 HOSPITAL AVE | ||||||||
| Address2: | |||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 068106099 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037396959 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2005 | ||||||||
| LastUpdateDate: | 12/11/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 51881 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 10110710-U104 | 01 | CDPHP | OTHER | 4830R1 | 01 | EMPIRE BC-BS | OTHER | P3506906 | 01 | OXFORD HEALTH PLAN | OTHER | 050923000060 | 01 | FIDELIS CARE OF NY | OTHER | 2590214 | 01 | GHI PPO | OTHER | 7297560 | 01 | AETNA-PPO | OTHER | 000000087400 | 01 | GHI-HMO | OTHER | 388165 | 01 | MVP HEALTHPLAN | OTHER | 3C5202 | 01 | HEALTHNET-GROUP ID | OTHER | 3760523 | 01 | AETNA HMO | OTHER |