Healthcare Provider Details

I. General information

NPI: 1770740300
Provider Name (Legal Business Name): BEAMON AGARWAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

794 ROBLE RD
ALLENTOWN PA
18109-9110
US

IV. Provider business mailing address

794 ROBLE RD
ALLENTOWN PA
18109-9110
US

V. Phone/Fax

Practice location:
  • Phone: 484-908-0319
  • Fax:
Mailing address:
  • Phone: 484-908-0319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberMD438246
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: