Healthcare Provider Details

I. General information

NPI: 1861291924
Provider Name (Legal Business Name): NIKITA AHUJA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2025
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BANNING ST STE 380
DOVER DE
19904-3493
US

IV. Provider business mailing address

2099 NEW ALBANY RD
CINNAMINSON NJ
08077-3534
US

V. Phone/Fax

Practice location:
  • Phone: 302-291-9900
  • Fax: 302-672-0879
Mailing address:
  • Phone: 609-926-8899
  • Fax: 856-772-1997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0012282
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA066389
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: