Provider Demographics
NPI:1720215817
Name:PANWAR, NIRMALA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIRMALA
Middle Name:
Last Name:PANWAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 PEMBROKE RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2626
Mailing Address - Country:US
Mailing Address - Phone:203-393-5280
Mailing Address - Fax:
Practice Address - Street 1:1783 MERIDEN WATERBURY TPKE #13
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-0648
Practice Address - Country:US
Practice Address - Phone:203-404-1010
Practice Address - Fax:860-426-2898
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT052442208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice