Doctor Name: | DR. NIRAJ KUMAR AGARWALLA |
NPI Number: | 1023374204 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | |
Business Practice Address: | 111 S 11th St Suite 8280 Philadelphia, PA - 191074824 |
Business Phone Number: | 2159552370 |
Business Fax Number: | 2159550677 |
Mailing Address: | 111 S 11th St, Suite 8280 PHILADELPHIA |
State: | PA |
Postal Code: | 191074824 |
Phone Number: | 2159552370 |
Fax Number: | 2159550677 |
NPI Enumeration Date: | 04/02/2012 |
NPI Last Update Date: | 05/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |