NPI 1285699488

Randy L Panke, NCCPA

Practitioner Physician Assistant Groton, CT

Practice location

Address: 159 Trout Ave Navsubase Nlon, Groton, CT 06349-5159
Phone: (860) 694-6464
Mailing address: Psc 1005 Box 11185, Fpo, AA 34009-0112

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Registry record

NPI: 1285699488
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Apr 2006
Record last updated: 24 Jul 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.