Provider Demographics
NPI:1124349683
Name:JAGTIANI, AARTI SUNDER
Entity type:Individual
Prefix:
First Name:AARTI
Middle Name:SUNDER
Last Name:JAGTIANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 HADDON CT
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08534-5261
Mailing Address - Country:US
Mailing Address - Phone:609-303-0168
Mailing Address - Fax:
Practice Address - Street 1:1700 N OLDEN AVE
Practice Address - Street 2:
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08638-3102
Practice Address - Country:US
Practice Address - Phone:609-896-9089
Practice Address - Fax:609-219-0603
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02946100183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist