S. B. & R. D. Ponamgi MD PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA03284500 Issued in NJ

Legal business name

S. B. & R. D. PONAMGI MD PA

Doing business as

SURI B. PONAMGI MD

Practice address

1101 Palisade Ave
Fort Lee, NJ 07024-6329

Phone

(201) 224-8831

Fax

(201) 224-9278

NPI assigned

Dec 12, 2012

Organization subpart

No

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

Authorized official

Name

Beygum Khan, BSN, CPC

Title

Office Manager

Phone

(201) 224-8831

Specialties & licenses 1

Addresses

Other names 1

• SURI B. PONAMGI MD Doing business as

Locations

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369872000000",
    "number": "1366788713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246329",
            "telephone_number": "201-224-8831",
            "fax_number": "201-224-9278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246329",
            "telephone_number": "201-224-8831",
            "fax_number": "201-224-9278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. B. & R. D. PONAMGI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2013-05-30",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "BEYGUM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-224-8831",
        "authorized_official_credential": "BSN, CPC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA03284500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SURI B. PONAMGI MD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2013; 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.