=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861291924
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NIKITA AHUJA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/11/2025
-----------------------------------------------------
Last Update Date | 10/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 BANNING ST STE 380
-----------------------------------------------------
City | DOVER
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19904-3493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 302-291-9900
-----------------------------------------------------
Fax | 302-672-0879
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2099 NEW ALBANY RD
-----------------------------------------------------
City | CINNAMINSON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08077-3534
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-926-8899
-----------------------------------------------------
Fax | 856-772-1997
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | C5-0012282
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | MA066389
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------