Provider Demographics
NPI:1346397296
Name:PUMARADA, ASHA (PT)
Entity Type:Individual
Prefix:MS
First Name:ASHA
Middle Name:
Last Name:PUMARADA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 NEWARK AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3560
Mailing Address - Country:US
Mailing Address - Phone:908-527-6001
Mailing Address - Fax:908-527-6634
Practice Address - Street 1:701 NEWARK AVE STE 212
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3560
Practice Address - Country:US
Practice Address - Phone:908-527-6001
Practice Address - Fax:908-527-6634
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00916700225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ081939S1UMedicare PIN