Basic Information
| Provider Information | |||||||||
| NPI: | 1942597588 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGGARWAL | ||||||||
| FirstName: | AAKASH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1130 MCBRIDE AVE FL 3 | ||||||||
| Address2: | |||||||||
| City: | WOODLAND PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 074243806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738121400 | ||||||||
| FaxNumber: | 9738121404 | ||||||||
| Practice Location | |||||||||
| Address1: | 52 1ST ST | ||||||||
| Address2: | |||||||||
| City: | HACKENSACK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076012044 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2014883003 | ||||||||
| FaxNumber: | 2014886911 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/04/2011 | ||||||||
| LastUpdateDate: | 04/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RG0100X | 275565-1 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 25MA11176400 | NJ | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
ID Information
| ID | Type | State | Issuer | Description | 0778567 | 05 | NJ | MEDICAID |