Provider Demographics
NPI:1598129272
Name:VAGHELA, DHARTI (NP-C)
Entity Type:Individual
Prefix:
First Name:DHARTI
Middle Name:
Last Name:VAGHELA
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:23 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5837
Practice Address - Country:US
Practice Address - Phone:844-362-1735
Practice Address - Fax:973-290-7495
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19975100163WG0000X
NYP99746208D00000X
NYF343655363LF0000X
NJ26NJ00912900363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice