Healthcare Provider Details

I. General information

NPI: 1881414415
Provider Name (Legal Business Name): POOJA ADHIKARI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

187 W MAIN ST
NEW LONDON OH
44851-1018
US

IV. Provider business mailing address

187 W MAIN ST
NEW LONDON OH
44851-1018
US

V. Phone/Fax

Practice location:
  • Phone: 419-929-0814
  • Fax: 419-929-0814
Mailing address:
  • Phone: 419-929-0814
  • Fax: 419-929-0814

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0034801
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: