Organization
GREATER HARTFORD OPHTHALMOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRASAD PANTHAGANI MD (MEMBER)
(860) 242-9090
Entity
Organization
Contact information
Practice address
701 COTTAGE GROVE RD, B210, BLOOMFIELD, CT 06002-3080
(860) 242-9090
(860) 242-9191
Mailing address
701 COTTAGE GROVE RD, B210, BLOOMFIELD, CT 06002-3080
(860) 242-9090
(860) 242-9191
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
044859
CT
Other
Enumeration date
12/24/2007
Last updated
01/04/2010
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