Individual
DR. PRASAD B PANTHAGANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 COTTAGE GROVE RD, SUITE B210, BLOOMFIELD, CT 06002-3080
(860) 242-9090
(860) 242-9191
Mailing address
701 COTTAGE GROVE ROAD, SUITE B210, BLOOMFIELD, CT 06002
(860) 242-9191
(860) 242-9090
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
044859
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001448598
—
CT
Enumeration date
11/07/2006
Last updated
03/21/2023
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