Healthcare Provider Details

I. General information

NPI: 1366855249
Provider Name (Legal Business Name): NITIN AGARWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EXCELA HEALTH DR STE 203B
LATROBE PA
15650-9001
US

IV. Provider business mailing address

100 EXCELA HEALTH DR STE 203B
LATROBE PA
15650-9001
US

V. Phone/Fax

Practice location:
  • Phone: 724-532-0866
  • Fax: 724-532-0869
Mailing address:
  • Phone: 724-532-0866
  • Fax: 724-532-0869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD479972
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: