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Individual
JYOTHSNA PONNURI
Active
Individual
JYOTHSNA PONNURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
237800
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
237800
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02708074
—
NY
01
—
P00388646
MEDICARE, RAILROAD
NY
Enumeration date
07/03/2006
Last updated
02/15/2016
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