Provider Demographics
NPI:1073572848
Name:JARIWALA, NILESH (MD FAAP)
Entity Type:Individual
Prefix:DR
First Name:NILESH
Middle Name:
Last Name:JARIWALA
Suffix:
Gender:M
Credentials:MD FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 HINCHMAN AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2360
Mailing Address - Country:US
Mailing Address - Phone:973-595-6996
Mailing Address - Fax:973-595-6706
Practice Address - Street 1:150 HINCHMAN AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2360
Practice Address - Country:US
Practice Address - Phone:973-595-6996
Practice Address - Fax:973-595-6706
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA52238208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJMA52238OtherLICENCE
BJ1572800OtherDEA
BJ1572800OtherDEA