Panda Medical PC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

253322 Issued in NY

Legal business name

PANDA MEDICAL PC

Practice address

340 Montauk Hwy
Suite 2
West Islip, NY 11795-4437

Phone

(631) 482-8824

Fax

(631) 482-8827

NPI assigned

Mar 14, 2011

Last updated

Mar 14, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sree P Panda, D.O

Title

President

Phone

(631) 482-8824

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300060800000",
    "number": "1851699946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MONTAUK HWY",
            "address_2": "SUITE 2",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954437",
            "telephone_number": "631-482-8824",
            "fax_number": "631-482-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MONTAUK HWY",
            "address_2": "SUITE 2",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954437",
            "telephone_number": "631-482-8824",
            "fax_number": "631-482-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANDA MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2011-03-14",
        "status": "A",
        "authorized_official_last_name": "PANDA",
        "authorized_official_first_name": "SREE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-482-8824",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "253322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in West Islip, NY
• Providers in West Islip, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2011; 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.