MEDIAID PC. NPI 1720282924

NPI Information

NPI: 1720282924
Provider Name: MEDIAID PC.,
Classification: Internal Medicine - 207RC0000X
Specialization: Cardiovascular Disease
Entity Type: Organization
:
Address: 1602 SAINT NICHOLAS AVE
NEW YORK, NY
ZIP 10040
Phone: (212) 795-4544

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NPI Details

MEDIAID PC., is a cardiovascular disease internal medicine in New York, NY. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. MEDIAID PC., NPI is 1720282924. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1602 SAINT NICHOLAS AVE
NEW YORK, NY
ZIP 10040-311
Phone: (212) 795-4544

The provider's authorized official is Atul K Agarwala .
The authorized official title is Director and has the following contact phone number (908) 222-8700.

The enumeration date for this NPI number is 6/12/2007 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	MA066725	NEW JERSEY	No
2	207W00000X	Ophthalmology		MA06158600	NEW JERSEY	No
3	207W00000X	Ophthalmology		1900871	NEW YORK	No
4	207RC0000X	Internal Medicine	Cardiovascular Disease	209747-1	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	01502661	MEDICAID	NEW JERSEY
2	01502661	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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