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Organization
PAVO CRISTATUS MEDICAL PC
Active
Organization
PAVO CRISTATUS MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAMKUMAR PANHANI MD (PRESIDENT)
(718) 464-0122
Entity
Organization
Contact information
Practice address
1010 NORTHERN BLVD STE 208, GREAT NECK, NY 11021-5320
(718) 464-0122
Mailing address
1010 NORTHERN BLVD STE 208, GREAT NECK, NY 11021-5320
(718) 464-0122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01583586
—
NY
Enumeration date
04/05/2019
Last updated
04/05/2019
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