Provider Demographics
NPI:1649703455
Name:JAGADISH, POOJA SONA (MD)
Entity type:Individual
Prefix:DR
First Name:POOJA
Middle Name:SONA
Last Name:JAGADISH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 WHITEHALL ROAD
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867
Mailing Address - Country:US
Mailing Address - Phone:603-841-2546
Mailing Address - Fax:833-406-1471
Practice Address - Street 1:21 WHITEHALL ROAD
Practice Address - Street 2:SUITE 300B
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867
Practice Address - Country:US
Practice Address - Phone:603-841-2546
Practice Address - Fax:833-406-1471
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1013096207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease