Active NPI
Poornima Katakam
- Physical Therapist
- Cranbury, NJ
National Provider Identifier
1619178019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40QA007065
- Practice address
- 61 Maplewood Ave
Elms of Cranbury
Cranbury, NJ 08512 - Phone
- (609) 395-3445
- Fax
- (609) 655-2052
- NPI assigned
- May 31, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40QA007065 | NJ | Primary |
Addresses
Primary practice location
61 Maplewood Ave
Elms of Cranbury
Cranbury, NJ 08512
Mailing address
59 Zaitz Farm Rd
Princeton JCT, NJ 08550
Phone (609) 716-9823
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40QA007065 | NJ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619178019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "59 ZAITZ FARM RD",
"city": "PRINCETON JCT",
"state": "NJ",
"postal_code": "08550",
"telephone_number": "609-716-9823",
"fax_number": "609-655-2052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 MAPLEWOOD AVE",
"address_2": "ELMS OF CRANBURY",
"city": "CRANBURY",
"state": "NJ",
"postal_code": "08512",
"telephone_number": "609-395-3445",
"fax_number": "609-655-2052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KATAKAM",
"first_name": "POORNIMA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NJ",
"license": "40QA007065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cranbury, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.