MEDICARE: MARIA C BANVARD DNP, NP, MSN, BSN

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	363LA2200X	Adult Health Nurse Practitioner	302783	NY

General Provider Information

NPI Number	:	1043281785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA C BANVARD DNP, NP, MSN, BSN

Provider Business Mailing Address
First Line	:	1000 FRANKLIN AVE LOWR LEVEL
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-2926
Country	:	US
Telephone Number	:	516-663-2367
Fax Number	:	516-663-2746

Provider Business Practice Location Address
First Line	:	1000 FRANKLIN AVE LOWR LEVEL
Second Line	:
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-2926
Country	:	US
Telephone Number	:	516-663-2367
Fax Number	:

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

Provider Enumeration Date	:	01/31/2006
Last Update Date	:	06/26/2023

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