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Dr. Suraj Pothineni, DO
Student in an Organized Health Care Education/Training Program in Hackensack, New Jersey
NPI 1679333124

Suraj Pothineni is a Student in an Organized Health Care Education/Training Program based in Hackensack, NJ. Suraj Pothineni practices in Hackensack, NJ and has the professional credentials of DO. The NPI Number for Suraj Pothineni is 1679333124 and holds a License No. (New Jersey).

The current practice location address for Suraj Pothineni is 30 Prospect Ave, Hackensack, NJ and can be reached out via phone at 551-996-2000.

Location: 30 Prospect Ave, Hackensack, NJ, 07601-1915
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679333124
Provider Name
Suraj Pothineni
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
30 Prospect Ave, Hackensack, NJ, 07601-1915
Phone Number
551-996-2000
Fax Number
Provider Enumeration Date
03/21/2024
Last Update Date
04/14/2024
institution
Provider Business Practice Location Address Details
Address
30 Prospect Ave
City
Hackensack
State
New Jersey
Zip
07601-1915
Phone Number
551-996-2000
Fax Number
person
Provider Business Mailing Address Details
Address
30 Prospect Ave
City
Hackensack
State
New Jersey
Zip
07601-1915
Phone Number
551-996-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(New Jersey)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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