Basic Information
Provider Information
NPI: 1417234121
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AGARWAL
FirstName: RITU
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2150 PENNSYLVANIA AVENUE
Address2: THE GW MEDICAL FACULTY ASSOCIATES
City: WASHINGTON
State: DC
PostalCode: 20037
CountryCode: US
TelephoneNumber:  
FaxNumber: 2027412185
Practice Location
Address1: 2150 PENNSYLVANIA AVENUE
Address2: THE GW MEDICAL FACULTY ASSOCIATES
City: WASHINGTON
State: DC
PostalCode: 20037
CountryCode: US
TelephoneNumber: 2027413000
FaxNumber: 2027412185
Other Information
ProviderEnumerationDate: 11/09/2011
LastUpdateDate: 11/09/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  Y Student, Health CareStudent in an Organized Health Care Education/Training Program 

No ID Information.


Home