Individual
AMY E BANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
114 WALTHAM ST, #17, LEXINGTON, MA 02421-5415
(781) 674-0200
Mailing address
4 BARBERRY RD, LEXINGTON, MA 02421-8004
(781) 674-0200
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
73645
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J11505
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/28/2006
Last updated
12/18/2007
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