Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MA07252400 | NJ |
N | 207QG0300X | Family Doctor - Geriatric Medicine | MA07252400 | NJ |
NPI | 1093795593 |
---|---|
Provider Name | Aruna Wadhwa |
First Address | Philadelphia, PA 19103-7334 |
Second Address | Stratford, NJ 08084-1354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 28/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8940002 | (05) | NJ |
H71653 | (02) | NJ |