Provider Demographics
NPI:1558535898
Name:GILOTRA, NISHA AGGARWAL
Entity Type:Individual
Prefix:MISS
First Name:NISHA
Middle Name:AGGARWAL
Last Name:GILOTRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NISHA
Other - Middle Name:
Other - Last Name:AGGARWAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:410-955-7963
Mailing Address - Fax:
Practice Address - Street 1:JOHNS HOPKINS HOSPITAL 1830 E MONUMENT ST
Practice Address - Street 2:SUITE 9020
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0020
Practice Address - Country:US
Practice Address - Phone:410-955-7963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD73345207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD241054Y82Medicare PIN