Provider Demographics
NPI:1730435686
Name:BATRA, POONAM
Entity type:Individual
Prefix:MS
First Name:POONAM
Middle Name:
Last Name:BATRA
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 1:3755 77TH ST APT 5J
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6621
Mailing Address - Country:US
Mailing Address - Phone:646-431-2309
Mailing Address - Fax:
Practice Address - Street 1:3755 77TH ST APT 5J
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6621
Practice Address - Country:US
Practice Address - Phone:646-431-2309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-30
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist