Individual provider Active NPI

Poonam Krunal Cholera

  • Physical Therapist
  • Philadelphia, PA
National Provider Identifier
1053640474
Registry record updated Dec 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT020319 Issued in PA
Practice address
1700 Benjamin Franklin Pkwy
Apartment-1714
Philadelphia, PA 19103-2735
Phone
(215) 796-3985
NPI assigned
Dec 14, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT020319 PA Primary

Addresses

Primary practice location

1700 Benjamin Franklin Pkwy
Apartment-1714
Philadelphia, PA 19103-2735

Mailing address

1700 Benjamin Franklin Pkwy
Apartment-1714
Philadelphia, PA 19103-2735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT020319PAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260748800000",
    "number": "1053640474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 BENJAMIN FRANKLIN PKWY",
            "address_2": "APARTMENT-1714",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 BENJAMIN FRANKLIN PKWY",
            "address_2": "APARTMENT-1714",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191032735",
            "telephone_number": "215-796-3985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOLERA",
        "first_name": "POONAM",
        "middle_name": "KRUNAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-14",
        "last_updated": "2009-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT020319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.