Provider Demographics
NPI:1023374204
Name:AGARWALLA, NIRAJ KUMAR (DO)
Entity Type:Individual
Prefix:DR
First Name:NIRAJ
Middle Name:KUMAR
Last Name:AGARWALLA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:111 S 11TH ST
Mailing Address - Street 2:SUITE 8280
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4824
Mailing Address - Country:US
Mailing Address - Phone:215-955-2370
Mailing Address - Fax:215-955-0677
Practice Address - Street 1:111 S 11TH STREET
Practice Address - Street 2:SUITE 8490
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4824
Practice Address - Country:US
Practice Address - Phone:215-955-6161
Practice Address - Fax:215-923-5507
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS018089207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine