Provider Demographics
NPI:1083972533
Name:VASWANI, NITA (DO)
Entity Type:Individual
Prefix:DR
First Name:NITA
Middle Name:
Last Name:VASWANI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 NEW PROVIDENCE RD
Mailing Address - Street 2:CHILDREN'S SPECIALIZED HOSPITAL
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2590
Mailing Address - Country:US
Mailing Address - Phone:888-244-5373
Mailing Address - Fax:
Practice Address - Street 1:150 NEW PROVIDENCE RD
Practice Address - Street 2:CHILDREN'S SPECIALIZED HOSPITAL
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2590
Practice Address - Country:US
Practice Address - Phone:888-244-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB099457002080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics