Provider Demographics
NPI:1992092993
Name:GARG, ADITI
Entity type:Individual
Prefix:
First Name:ADITI
Middle Name:
Last Name:GARG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2855 CAMPUS DR STE 660
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2665
Mailing Address - Country:US
Mailing Address - Phone:763-577-7900
Mailing Address - Fax:763-577-7905
Practice Address - Street 1:2855 CAMPUS DR STE 660
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2665
Practice Address - Country:US
Practice Address - Phone:763-577-7900
Practice Address - Fax:763-577-7905
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN577442084P0804X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry