| Doctor Name: | DR. NAFISA Z. POONAWALA |
| NPI Number: | 1700812617 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 25MA04302700 |
| Business Practice Address: | Rahway Avenue Woodbridge Developmental Center Woodbridge, NJ - 070950189 |
| Business Phone Number: | 7324995951 |
| Business Fax Number: | |
| Mailing Address: | State Of Nj Dept. Of Treasury, Po Box 15280 NEWARK |
| State: | NJ |
| Postal Code: | 071920001 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2006 |
| NPI Last Update Date: | 10/19/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25MA04302700 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |