Provider Demographics
NPI:1588821904
Name:NIJHAWAN, SHEETAL
Entity Type:Individual
Prefix:DR
First Name:SHEETAL
Middle Name:
Last Name:NIJHAWAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 GARDEN WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-5215
Mailing Address - Country:US
Mailing Address - Phone:724-981-0630
Mailing Address - Fax:724-981-4561
Practice Address - Street 1:2425 GARDEN WAY STE 101
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-5215
Practice Address - Country:US
Practice Address - Phone:724-981-0630
Practice Address - Fax:724-981-7379
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA 112044208600000X
PAMD448894208600000X
AL31119208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA296062J4NMedicare PIN