Provider Demographics
NPI:1275370702
Name:PANCHAL, KEYUR DHIRENDRAKUMAR (MBBS DPM)
Entity type:Individual
Prefix:
First Name:KEYUR
Middle Name:DHIRENDRAKUMAR
Last Name:PANCHAL
Suffix:
Gender:M
Credentials:MBBS DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH
Mailing Address - Street 2:HEALTH SCIENCES TOWER, T10 -020
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11794
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF PSYCHIATRY AND BEHAVIORAL HEALTH
Practice Address - Street 2:HEALTH SCIENCES TOWER, T10 -020
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794
Practice Address - Country:US
Practice Address - Phone:631-444-3406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program