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NPI Code Detail

MEDICARE: DR. DIPAK S BANKER M.D.

MEDICARE: DR. DIPAK S BANKER M.D.
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
1208000000XPediatrics Physician136434NY

General Provider Information

NPI Number : 1851374870
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIPAK S BANKER M.D.
Provider Business Mailing Address
First Line : 155 CRYSTAL RUN RD
Second Line :
City : MIDDLETOWN
State : NY
Zip : 10941-4028
Country : US
Telephone Number : 845-703-6999
Fax Number : 845-703-6297
Provider Business Practice Location Address
First Line : 48 NEW MAIN ST
Second Line :
City : HAVERSTRAW
State : NY
Zip : 10927-1812
Country : US
Telephone Number : 845-429-3382
Fax Number : 845-429-2057
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2005
Last Update Date : 07/31/2020

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