Individual
MADHURI PONNALURI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
(973) 676-1396
Mailing address
741 BROADWAY, NEWARK, NJ 07104-4309
(973) 483-1300
(973) 676-1396
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
26NJ01197700
NJ
Other
Enumeration date
07/29/2021
Last updated
03/14/2024
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