Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD458507 | PA |
N | 207KA0200X | Allergist | C10011774 | DE |
N | 208000000X | Pediatrician | C10011774 | DE |
N | 2080P0201X | Pediatric Allergist | C10011774 | DE |
NPI | 1336465343 |
---|---|
Provider Name | Niti Agarwal |
First Address | Berwyn, PA 19312-2147 |
Second Address | Blue Bell, PA 19422-2332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2010 |
Last Update Date | 22/10/2021 |