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Individual

RICHARD WINGATE PANNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
215 WEST 125TH ST, RENAISSANCE HCN 2ND FLOOR, NEW YORK, NY 10027
(212) 932-6514
Mailing address
875 BOYNTON AVENUE, #2K, BRONX, NY 10473-4748
(718) 378-0735

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N0026771
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00406184
NY
Enumeration date
11/22/2006
Last updated
07/08/2007
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