Provider Demographics
NPI:1497044754
Name:MARINESCU, PONNILA SUNDERI (MD)
Entity Type:Individual
Prefix:
First Name:PONNILA
Middle Name:SUNDERI
Last Name:MARINESCU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PONNILA
Other - Middle Name:SUNDERI
Other - Last Name:SAMUEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:601 ELMWOOD AVE BOX 668
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-7480
Mailing Address - Fax:
Practice Address - Street 1:500 RED CREEK DR STE 210
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14623-4285
Practice Address - Country:US
Practice Address - Phone:585-487-3350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292051207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology