MEDICARE: DR. SUBHASHIS BANERJEE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01068926A	IN

General Provider Information

NPI Number	:	1013074418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUBHASHIS BANERJEE M.D.

Provider Business Mailing Address
First Line	:	60 TREETOPS CIR
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-8581
Country	:	US
Telephone Number	:	609-997-0690
Fax Number	:

Provider Business Practice Location Address
First Line	:	3551 LAWRENCEVILLE RD
Second Line	:
City	:	PRINCETON
State	:	NJ
Zip	:	08540-4715
Country	:	US
Telephone Number	:	609-252-7269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/03/2007
Last Update Date	:	04/21/2014

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