Basic Information
| Provider Information | |||||||||
| NPI: | 1548234800 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGGARWAL | ||||||||
| FirstName: | ACHAL | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 NEPONSET ST FL STREET2 | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016062714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088325917 | ||||||||
| FaxNumber: | 5088325751 | ||||||||
| Practice Location | |||||||||
| Address1: | 385 SOUTHBRIDGE ST | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | MA | ||||||||
| PostalCode: | 015012498 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5088325917 | ||||||||
| FaxNumber: | 5088325751 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 03/13/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 79030 | MA | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 043058466 | 01 | TRICARE CHAMPUS | OTHER | 916010 | 01 | FIRST HEALTH | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 2040544 | 01 | CIGNA HEALTH PLAN | OTHER | J14820 | 01 | BLUE SHIELD HMO BLUE | OTHER | 26835 | 01 | CHILDRENS MEDICAL SECURIT | OTHER | 3128989 | 01 | WELFARE | OTHER | 991102 | 01 | FALLON COMMUNITY HEALTH P | OTHER | J14820 | 01 | BLUE CARE ELECT | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 4674196 | 01 | AETNA US HEALTHCARE | OTHER | J14820 | 01 | MEDICARE B | OTHER | 042472266 | 01 | THREE RIVERS | OTHER | 3128989 | 05 | MA | MEDICAID | 784234 | 01 | MVP HEALTH CARE | OTHER | AA1166 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | J14820 | 01 | BLUE SHIELD INDEMNITY | OTHER | 043058466 | 01 | HEALTHCARE VALUE MANAGEME | OTHER |