Provider Demographics
NPI:1619451861
Name:AGRAWAL, NIDHI (RDN)
Entity Type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:
Last Name:AGRAWAL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 NINTH ST
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4877
Mailing Address - Country:US
Mailing Address - Phone:856-520-3451
Mailing Address - Fax:
Practice Address - Street 1:4 NINTH ST
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-4877
Practice Address - Country:US
Practice Address - Phone:856-520-3451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-23
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ873584133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered