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NPI 1083523617

NPI 1083523617 : JANE BANATTE PA-C : EAST MEADOW, NY

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General NPI Number Information
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    NPI Number           |    1083523617
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    Entity Type          |    Individual 
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    Provider Name        |    JANE BANATTE PA-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/01/2026
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    Last Update Date     |    09/02/2026
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Provider Practice Location Address
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    Address Line         |    30 MERRICK AVE STE 103 
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    City                 |    EAST MEADOW
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    State                |    NY
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    Zip                  |    11554-1580
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    Country              |    US
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    Telephone            |    516-743-9450
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    30 MERRICK AVE STE 103 
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    City                 |    EAST MEADOW
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    State                |    NY
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    Zip                  |    11554-1580
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    036570
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    License Number State |    NY
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