Provider Demographics
NPI:1801945381
Name:WADHWA, RAJESH (MD)
Entity type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:WADHWA
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 1:2 HIDDEN HOLLOW DR
Mailing Address - Street 2:YARDVILLE
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08620-9513
Mailing Address - Country:US
Mailing Address - Phone:609-510-4041
Mailing Address - Fax:
Practice Address - Street 1:WHOLEHEALTH-CONTINENTAL CLINIC
Practice Address - Street 2:STE.136, TERMINALC, NEWARK LIBERTYINTERNATIONAL AIRPORT
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-3799
Practice Address - Country:US
Practice Address - Phone:973-681-1700
Practice Address - Fax:973-681-1189
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06327800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJWA459706Medicare PIN
NJG40243Medicare UPIN