Individual
DR. NAFISA Z. POONAWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
RAHWAY AVENUE, WOODBRIDGE DEVELOPMENTAL CENTER, WOODBRIDGE, NJ 07095-0189
(732) 499-5951
Mailing address
STATE OF NJ DEPT. OF TREASURY, PO BOX 15280, NEWARK, NJ 07192-0001
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
25MA04302700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
666195B1F
MEDICARE BILLING NUMBER
—
Enumeration date
06/23/2006
Last updated
10/19/2007
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