Lakshmi Gopalan Poranki

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

027449 Issued in NY

Practice address

3908 Fuller Hollow Rd
Vestal, NY 13850-5540

Phone

(607) 763-4315

NPI assigned

Mar 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1584489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1205462652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 FULLER HOLLOW RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138505540",
            "telephone_number": "607-763-4315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3908 FULLER HOLLOW RD",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138505540",
            "telephone_number": "607-763-4315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORANKI",
        "first_name": "LAKSHMI",
        "middle_name": "GOPALAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-18",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "027449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew M Polak
• Jane Polhamus, NP
• Kristie Poncelet
• Sudhan Paulthurai Ponnaiahnadar, PT
• Jacqueline Ann Ponticiello, NPP, FNP
• Leida M Portela, DDS
• Sophie Lynn Portnoy, RPH
• Aastha Poudel
• Michael Powell, MD
• Emily Prescott

• Physical Therapist in Vestal, NY
• Providers in Vestal, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.