Provider Demographics
NPI:1114716271
Name:POONAMALLEE KOTHANDARAMAN, SANAADHAN
Entity type:Individual
Prefix:DR
First Name:SANAADHAN
Middle Name:
Last Name:POONAMALLEE KOTHANDARAMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:SANAADHAN
Other - Middle Name:
Other - Last Name:POONAMALLEE KOTHANDARAMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:70 DUBOIS STREET, MONTEFIORE ST. LUKE' CORNWALL HOSPITA
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550
Mailing Address - Country:US
Mailing Address - Phone:845-561-4400
Mailing Address - Fax:845-784-3960
Practice Address - Street 1:70 DUBOIS STREET, MONTEFIORE ST. LUKE' CORNWALL HOSPITA
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-561-4400
Practice Address - Fax:845-784-3960
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program