Healthcare Provider Details

I. General information

NPI: 1255715090
Provider Name (Legal Business Name): NIKHITA DHARBHAMULLA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 OLD LANCASTER RD STE 340
BRYN MAWR PA
19010-3235
US

IV. Provider business mailing address

825 OLD LANCASTER RD STE 320
BRYN MAWR PA
19010-3235
US

V. Phone/Fax

Practice location:
  • Phone: 610-525-9570
  • Fax: 610-527-8805
Mailing address:
  • Phone: 610-527-3800
  • Fax: 610-527-0334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number390200000X3
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD477919
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: