# MANUEL B BANZON MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730262536
- **Authorized official:** MANUEL BANZON M.D. (OWNER)
- **Authorized official phone:** (201) 864-4442

## Contact information

- **Practice address:** 1265 PATERSON PLANK RD, SUITE 3D, SECAUCUS, NJ 07094-3242
- **Practice address phone:** (201) 864-4442
- **Practice address fax:** (201) 864-5038
- **Mailing address:** 1265 PATERSON PLANK RD, SUITE 3D, SECAUCUS, NJ 07094-3242
- **Mailing address phone:** (201) 864-4442
- **Mailing address fax:** (201) 864-5038

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | MA27187 | NJ | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 03/18/2014