Individual
JOHN R PANNESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Mailing address
950 CAMPBELL AVE, WEST HAVEN, CT 06516-2770
(203) 932-5711
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
032701
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1327015
—
CT
Enumeration date
10/12/2005
Last updated
09/10/2015
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