| Copper Canyon Care PC | |
|
5 Research Dr Shelton CT 06484-6232 | |
| (203) 901-2493 | |
| Not Available |
| Full Name | Copper Canyon Care PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 5 Research Dr, Shelton, Connecticut |
| Authorized Official Name and Position | Manoj Wadhwani (OWNER) |
| Authorized Official Contact | 2039012493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Copper Canyon Care PC 5 Research Dr Shelton CT 06484-6232 Ph: (203) 901-2493 | Copper Canyon Care PC 5 Research Dr Shelton CT 06484-6232 Ph: (203) 901-2493 |
| NPI Number | 1871386821 |
|---|---|
| Provider Enumeration Date | 05/23/2025 |
| Last Update Date | 05/23/2025 |
| Certification Date | 05/23/2025 |
| Medicare PECOS PAC ID | 9335653823 |
|---|---|
| Medicare Enrollment ID | O20250708001529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871386821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Primary |
| Provider Name | David Penry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306849922 PECOS PAC ID: 0648223255 Enrollment ID: I20050224000013 |
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