Individual
SREE P PANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
585 SCHENECTADY AVE, BROOKLYN, NY 11203-1822
(877) 866-7123
Mailing address
205 W 54TH ST APT 1D, NEW YORK, NY 10019-5512
(718) 440-0445
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
253322
NY
208D00000X
General Practice Physician
253322
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000000
NONE
—
Enumeration date
04/01/2011
Last updated
09/21/2018
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