Individual
POONAM SONI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
697 MILL CREEK ROAD SUITE 1, MANAHAWKIN, NJ 08050
(609) 597-5699
(609) 597-5277
Mailing address
697 MILLCREEK ROAD SUITE 1, MANAHAWKIN, NJ 08050-3361
(609) 597-5699
(609) 597-5722
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07986500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
117106W76
MEDICARE GROUP PTAN
NJ
Enumeration date
10/04/2006
Last updated
09/27/2012
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