Provider Demographics
NPI:1821174483
Name:AGARWAL, ASHISH M (MD)
Entity Type:Individual
Prefix:
First Name:ASHISH
Middle Name:M
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 PHEASANT RUN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-3439
Mailing Address - Country:US
Mailing Address - Phone:215-860-3344
Mailing Address - Fax:215-860-8950
Practice Address - Street 1:1 UNION ST
Practice Address - Street 2:SUITE 101
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-4219
Practice Address - Country:US
Practice Address - Phone:609-890-7292
Practice Address - Fax:215-860-8950
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD429787207R00000X, 207RC0000X
NJ25MA08539000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
223505477OtherTIN
232571699OtherTIN
462009036OtherTIN