Individual
VIKRAM ETTIGOUNDER PONNUSAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 PLUM ST STE 600, NEW BRUNSWICK, NJ 08901-2065
(732) 220-1600
(732) 466-9661
Mailing address
420 MOUNTAIN AVE FL 4, NEW PROVIDENCE, NJ 07974-2736
(908) 458-8333
(908) 967-5488
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
25MA12225600
NJ
Other
Enumeration date
04/21/2020
Last updated
06/10/2024
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