Provider Demographics
NPI:1306942800
Name:NAGPAL, INDERJEET SINGH (MD)
Entity type:Individual
Prefix:
First Name:INDERJEET
Middle Name:SINGH
Last Name:NAGPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 MONTAUK HWY
Mailing Address - Street 2:STE4
Mailing Address - City:WEST ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11795-4939
Mailing Address - Country:US
Mailing Address - Phone:631-422-9600
Mailing Address - Fax:631-422-9697
Practice Address - Street 1:1175 MONTAUK HWY
Practice Address - Street 2:STE4
Practice Address - City:WEST ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11795-4939
Practice Address - Country:US
Practice Address - Phone:631-422-9600
Practice Address - Fax:631-422-9697
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY209194208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG50654Medicare UPIN