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General NPI Number Information
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NPI Number | 1629135470
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Entity Type | Individual
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Provider Name | ERNESTO E BANALAGAY M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1711 27TH ST BRAUNLIN BLDG STE 301
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2638
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Country | US
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Telephone | 740-356-5393
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Fax | 740-356-7804
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Provider Business Mailing Address
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Address Line | 1735 27TH ST STE B06
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2681
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Country | US
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Telephone | 740-356-8681
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Fax | 740-356-1256
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 35073970
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License Number State | OH
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