Provider Demographics
NPI:1871558247
Name:AGARWAL, LINDA (CRNA)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 DEERHILL DR
Mailing Address - Street 2:
Mailing Address - City:HO HO KUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07423-1705
Mailing Address - Country:US
Mailing Address - Phone:401-742-7331
Mailing Address - Fax:201-444-7228
Practice Address - Street 1:7 DEERHILL DR
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1705
Practice Address - Country:US
Practice Address - Phone:401-742-7331
Practice Address - Fax:201-444-7228
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA242776367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANA1151Medicare ID - Type Unspecified