Organization
PRESTIGE MEDICAL CONCIERGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSAMA KANDALAFT MD (OWNER)
(475) 837-8701
Entity
Organization
Contact information
Practice address
25 STEVENS STREET, EAST HAVEN, CT 06512
(475) 837-8701
Mailing address
25 STEVENS STREET, EAST HAVEN, CT 06512
(475) 837-8701
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
063900
STATE LICENSE
CT
Enumeration date
12/09/2021
Last updated
12/09/2021
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