Healthcare Provider Details

I. General information

NPI: 1003875410
Provider Name (Legal Business Name): BANANI SAHA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 01/30/2021
Certification Date: 01/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2140 FISHER RD
MECHANICSBURG PA
17055-5122
US

IV. Provider business mailing address

2140 FISHER RD
MECHANICSBURG PA
17055-5122
US

V. Phone/Fax

Practice location:
  • Phone: 717-766-1795
  • Fax: 717-697-6575
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD072987L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: