MEDICARE: HARSHITA AGGARWAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	2305215678	VA

General Provider Information

NPI Number	:	1215627211
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARSHITA AGGARWAL

Provider Business Mailing Address
First Line	:	177 RAVENSBOURNE TRCE
Second Line	:
City	:	STOKESDALE
State	:	NC
Zip	:	27357-8668
Country	:	US
Telephone Number	:	276-734-1145
Fax Number	:

Provider Business Practice Location Address
First Line	:	2700 GREENSBORO RD
Second Line	:
City	:	MARTINSVILLE
State	:	VA
Zip	:	24112-8107
Country	:	US
Telephone Number	:	276-632-1884
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2023
Last Update Date	:	05/11/2023

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