Provider Demographics
NPI:1336465343
Name:AGARWAL, NITI
Entity Type:Individual
Prefix:
First Name:NITI
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NITI
Other - Middle Name:
Other - Last Name:SARDANA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1168 PEBBLE SPRING DR
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:PA
Mailing Address - Zip Code:19312-2147
Mailing Address - Country:US
Mailing Address - Phone:413-896-6370
Mailing Address - Fax:
Practice Address - Street 1:470 SENTRY PKWY E STE 200
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2332
Practice Address - Country:US
Practice Address - Phone:610-825-5800
Practice Address - Fax:610-397-0980
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10011774207KA0200X, 208000000X, 2080P0201X
PAMD458507207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology