Provider Demographics
NPI:1801942065
Name:POONAI, DEVINDRA (DPM)
Entity type:Individual
Prefix:DR
First Name:DEVINDRA
Middle Name:
Last Name:POONAI
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-2443
Mailing Address - Country:US
Mailing Address - Phone:732-246-1377
Mailing Address - Fax:732-246-0858
Practice Address - Street 1:602 LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-2443
Practice Address - Country:US
Practice Address - Phone:732-246-1377
Practice Address - Fax:732-246-0858
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD02222213EP1101X, 213ES0131X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU42706Medicare UPIN
NJ757157Medicare ID - Type Unspecified