Provider Demographics
NPI:1346602125
Name:AGRAWAL, ASHWIN (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHWIN
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 WYCKOFF ROAD
Mailing Address - Street 2:SUITE 4200
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724
Mailing Address - Country:US
Mailing Address - Phone:732-923-6080
Mailing Address - Fax:732-923-6089
Practice Address - Street 1:200 WYCKOFF ROAD
Practice Address - Street 2:SUITE 4200
Practice Address - City:EATONTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07724
Practice Address - Country:US
Practice Address - Phone:732-923-6080
Practice Address - Fax:732-923-6089
Is Sole Proprietor?:No
Enumeration Date:2016-03-22
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB120066002080P0206X
NY298710390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology