Individual
MS. CYNTHIA A PANGALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
888 THACKERAY TRL STE 103, OCONOMOWOC, WI 53066-4342
(262) 567-1499
(262) 567-4502
Mailing address
888 THACKERAY TRL STE 103, OCONOMOWOC, WI 53066-4342
(262) 567-1499
(262) 567-4502
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32603
WI
2086S0129X
Vascular Surgery Physician
32603
WI
208C00000X
Colon & Rectal Surgery Physician
32603
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317237300
—
WI
Enumeration date
03/23/2006
Last updated
03/17/2018
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