Basic Information
| Provider Information | |||||||||
| NPI: | 1992806400 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AGGARWAL | ||||||||
| FirstName: | NEENA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1265 FRANKLIN AVE | ||||||||
| Address2: | MLKJR HEALTH CENTER, 3RD FLOOR, PEDIATRICS | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104563501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185037700 | ||||||||
| FaxNumber: | 7185037712 | ||||||||
| Practice Location | |||||||||
| Address1: | 1265 FRANKLIN AVE | ||||||||
| Address2: | MLKJR HEALTH CENTER, 3RD FLOOR, PEDIATRICS | ||||||||
| City: | BRONX | ||||||||
| State: | NY | ||||||||
| PostalCode: | 104563501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7185037700 | ||||||||
| FaxNumber: | 7185037741 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2006 | ||||||||
| LastUpdateDate: | 05/07/2013 | ||||||||
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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 | 208000000X | 147333 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 00244573 | 05 | NY | MEDICAID | 147333 | 01 | NY | MEDICAL LICENCE | OTHER | AA1449025 | 01 | DEA NUMBER | OTHER |