Provider Demographics
NPI:1588942643
Name:AGGARWAL, SUDHIR (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:SUDHIR
Middle Name:
Last Name:AGGARWAL
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W LANCASTER AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1751
Mailing Address - Country:US
Mailing Address - Phone:484-413-2572
Mailing Address - Fax:484-413-2611
Practice Address - Street 1:250 W LANCASTER AVE STE 220
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1751
Practice Address - Country:US
Practice Address - Phone:484-413-2572
Practice Address - Fax:484-413-2611
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-23
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4539732084V0102X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology