Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 25MA07791800 | NJ |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 25MA07791800 | NJ |
NPI | 1245246982 |
---|---|
Provider Name | Dr. Nidhi Agrawal |
First Address | Camden, NJ 08103-1155 |
Second Address | Thorofare, NJ 08086 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 09/05/2016 |