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Organization

PRESTIGE PODIATRY CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHIVANI PANCHAL DPM (PODIATRIST)
(860) 930-7335
Entity
Organization

Contact information

Practice address
296 SOUND BEACH AVE, OLD GREENWICH, CT 06870-1626
(203) 563-8383
Mailing address
296 SOUND BEACH AVE, OLD GREENWICH, CT 06870-1626
(203) 563-8383

Taxonomy

Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1295267730
PODIATRY
CT
Enumeration date
01/30/2023
Last updated
09/05/2023
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