Basic Information
Provider Information
NPI: 1598962474
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGGARWAL
FirstName: NITI
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 1ST ST SW
Address2:  
City: ROCHESTER
State: MN
PostalCode: 559050002
CountryCode: US
TelephoneNumber: 5072842511
FaxNumber:  
Practice Location
Address1: 1025 MARSH ST
Address2:  
City: MANKATO
State: MN
PostalCode: 560014752
CountryCode: US
TelephoneNumber: 5076254031
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/02/2007
LastUpdateDate: 10/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X50746MNN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000X64228WIN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
2085R0202X64228WIN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
207RC0000X50746MNY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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