Healthcare Provider Details

I. General information

NPI: 1093795593
Provider Name (Legal Business Name): ARUNA WADHWA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 12/28/2021
Certification Date: 12/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 LAUREL RD E UDP #1800
STRATFORD NJ
08084-1354
US

IV. Provider business mailing address

1650 MARKET ST STE 3600
PHILADELPHIA PA
19103-7334
US

V. Phone/Fax

Practice location:
  • Phone: 856-566-6843
  • Fax: 856-566-6781
Mailing address:
  • Phone: 866-949-0108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMA07252400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberMA07252400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: