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NPI Code Detail

MEDICARE: DAVID BARRETT BANACH MD

MEDICARE:   DAVID BARRETT BANACH  MD
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
1207R00000XInternal Medicine Physician248594NY
2390200000XStudent in an Organized Health Care Education/Training Program
3207RI0200XInfectious Disease Physician050736CT

General Provider Information

NPI Number : 1639380256
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID BARRETT BANACH MD
Provider Business Mailing Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4225
Fax Number : 860-679-1217
Provider Business Practice Location Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-4225
Fax Number : 860-679-1217
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2007
Last Update Date : 09/28/2022

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Directions to “ DAVID BARRETT BANACH MD” Practice Location

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