Provider Demographics
NPI:1881414415
Name:ADHIKARI, POOJA
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:ADHIKARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:44851-1018
Mailing Address - Country:US
Mailing Address - Phone:419-929-0814
Mailing Address - Fax:419-929-0814
Practice Address - Street 1:187 W MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:OH
Practice Address - Zip Code:44851-1018
Practice Address - Country:US
Practice Address - Phone:419-929-0814
Practice Address - Fax:419-929-0814
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0034801363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily