Individual
BALAMURUGAN PONNURAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP-BC
Contact information
Practice address
968 FAIRFIELD AVE, BRIDGEPORT, CT 06605-1116
(203) 330-6000
Mailing address
46 ALBION ST, BRIDGEPORT, CT 06605-2602
(203) 330-6000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9832
CT
Other
Enumeration date
02/04/2022
Last updated
02/04/2022
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