Deborah Pan MD LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

041129 Issued in CT

Legal business name

DEBORAH PAN MD LLC

Practice address

1 Audubon St
Suite 201
New Haven, CT 06511-6433

Phone

(203) 562-7662

Fax

(203) 562-7663

NPI assigned

May 5, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Deborah Pan, M.D.

Title

Owner

Phone

(203) 562-7662

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430784000000",
    "number": "1659758191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 AUDUBON ST",
            "address_2": "SUITE 201",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116433",
            "telephone_number": "203-562-7662",
            "fax_number": "203-562-7663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 AUDUBON ST",
            "address_2": "SUITE 201",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116433",
            "telephone_number": "203-562-7662",
            "fax_number": "203-562-7663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEBORAH PAN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-05",
        "last_updated": "2015-05-05",
        "status": "A",
        "authorized_official_last_name": "PAN",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-562-7662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "CT",
            "license": "041129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Plastic and Reconstructive Surgery Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Plastic and Reconstructive Surgery Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.