Basic Information
| Provider Information | |||||||||
| NPI: | 1659629657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RUFUS PONNIAH | ||||||||
| FirstName: | SHARAN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10111 95TH ST | ||||||||
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| City: | OZONE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 114162506 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3309909276 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2600 SIXTH ST SW STE 710 | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447101702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3304548076 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2012 | ||||||||
| LastUpdateDate: | 06/25/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 06/25/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.126952 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0011X | 35.126952 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.