MEDICARE: MILANA BANTON

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	101Y00000X	Counselor		NY

General Provider Information

NPI Number	:	1285393132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILANA BANTON

Provider Business Mailing Address
First Line	:	11470 199TH ST PH
Second Line	:
City	:	SAINT ALBANS
State	:	NY
Zip	:	11412-2823
Country	:	US
Telephone Number	:	917-683-7719
Fax Number	:

Provider Business Practice Location Address
First Line	:	174 HUDSON ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10013-2161
Country	:	US
Telephone Number	:	646-370-3113
Fax Number	:

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

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	12/08/2021

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Directions to “ MILANA BANTON ” Practice Location

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