Healthcare Provider Details

I. General information

NPI: 1801753413
Provider Name (Legal Business Name): POOJA LINGAMNENI PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5910 CLEVELAND AVE
COLUMBUS OH
43231-6881
US

IV. Provider business mailing address

6445 HILLTOP TRAIL DR
NEW ALBANY OH
43054-5009
US

V. Phone/Fax

Practice location:
  • Phone: 614-888-2450
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.010338RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: