Individual provider Active NPI

Ponnamma G Kaimulayil

  • Registered Nurse
  • East Hanover, NJ
National Provider Identifier
1609050459
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
26NR08565100 Issued in NJ
Practice address
75 Tanglewood Dr
East Hanover, NJ 07936-3306
Phone
(973) 585-4000
NPI assigned
Dec 27, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 26NR08565100 NJ Primary

Addresses

Primary practice location

75 Tanglewood Dr
East Hanover, NJ 07936-3306

Mailing address

75 Tanglewood Dr
East Hanover, NJ 07936-3306
Phone (973) 585-4000

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
26NR08565100NJMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1609050459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 TANGLEWOOD DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363306",
            "telephone_number": "973-585-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 TANGLEWOOD DR",
            "city": "EAST HANOVER",
            "state": "NJ",
            "postal_code": "079363306",
            "telephone_number": "973-585-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAIMULAYIL",
        "first_name": "PONNAMMA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NJ",
            "license": "26NR08565100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hanover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2007; 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.