Provider Demographics
NPI:1306262035
Name:AGARWAL, SUMIT (DO)
Entity type:Individual
Prefix:
First Name:SUMIT
Middle Name:
Last Name:AGARWAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 US HIGHWAY 22 E FL 3
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE STATION
Mailing Address - State:NJ
Mailing Address - Zip Code:08889-3696
Mailing Address - Country:US
Mailing Address - Phone:908-237-4155
Mailing Address - Fax:908-534-6634
Practice Address - Street 1:537 US HIGHWAY 22 E FL 3
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE STATION
Practice Address - State:NJ
Practice Address - Zip Code:08889-3696
Practice Address - Country:US
Practice Address - Phone:908-237-4155
Practice Address - Fax:908-534-6634
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB10095900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine