MEDICARE: NIKITA JANODIA PA-C

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	363A00000X	Physician Assistant	034806	NY

General Provider Information

NPI Number	:	1861356479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKITA JANODIA PA-C

Provider Business Mailing Address
First Line	:	4510 CODDINGTON LOOP APT 203
Second Line	:
City	:	WILMINGTON
State	:	NC
Zip	:	28405-6566
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 BRADHURST AVE
Second Line	:
City	:	HAWTHORNE
State	:	NY
Zip	:	10532-2140
Country	:	US
Telephone Number	:	609-532-4830
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	01/27/2026

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Directions to “ NIKITA JANODIA PA-C” Practice Location

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