Nafisa Z. Poonawala, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

25MA04302700 Issued in NJ

Practice address

Rahway Avenue
Woodbridge Developmental Center
Woodbridge, NJ 07095-0189

Phone

(732) 499-5951

NPI assigned

Jun 23, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1700812617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "STATE OF NJ DEPT. OF TREASURY",
            "address_2": "PO BOX 15280",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071920001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RAHWAY AVENUE",
            "address_2": "WOODBRIDGE DEVELOPMENTAL CENTER",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070950189",
            "telephone_number": "732-499-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POONAWALA",
        "first_name": "NAFISA",
        "middle_name": "Z.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NJ",
            "license": "25MA04302700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE BILLING NUMBER",
            "identifier": "666195B1F",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Woodbridge, NJ
• Providers in Woodbridge, NJ by specialty
• General Practice Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.