Individual
VIGNESH PONNUSAMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-6000
Mailing address
864 49TH ST APT C18, BROOKLYN, NY 11220-2442
(404) 723-5954
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD16987
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/24/2015
Last updated
06/19/2020
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