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Individual

SETH BANEVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
270 FARMINGTON AVE STE 309, FARMINGTON, CT 06032-1953
(860) 677-5570
(860) 677-9570
Mailing address
263 FARMINGTON AVE, UCONN SCHOOL OF MEDICINE, PSYCHIATRY, C/O TERRI CARRIER, FARMINGTON, CT 06030-2103
(860) 679-4733

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
629921
CT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1013302264
CT
Enumeration date
04/04/2015
Last updated
05/31/2019
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