Provider Demographics
NPI:1881783785
Name:WADHWA, NANDITA (MD)
Entity type:Individual
Prefix:DR
First Name:NANDITA
Middle Name:
Last Name:WADHWA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 OVERLOOK WAY
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-1341
Mailing Address - Country:US
Mailing Address - Phone:631-246-9178
Mailing Address - Fax:
Practice Address - Street 1:79 MIDDLEVILLE ROAD
Practice Address - Street 2:VETERANS ADMINISTRATION MEDICAL CENTER
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768
Practice Address - Country:US
Practice Address - Phone:631-261-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197157-12085B0100X, 2085R0202X, 2085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Not Answered2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound