Provider Demographics
NPI:1750647343
Name:AGARWAL, SHILPA R (MD)
Entity Type:Individual
Prefix:
First Name:SHILPA
Middle Name:R
Last Name:AGARWAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:182 SOUTH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5377
Mailing Address - Country:US
Mailing Address - Phone:973-267-0300
Mailing Address - Fax:973-695-1480
Practice Address - Street 1:182 SOUTH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-5377
Practice Address - Country:US
Practice Address - Phone:973-267-0300
Practice Address - Fax:973-695-1480
Is Sole Proprietor?:No
Enumeration Date:2012-04-08
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA09771400207N00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207N00000XAllopathic & Osteopathic PhysiciansDermatology