Individual
DR. SAMUEL A BANIGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,
Contact information
Practice address
40 UNION AVE, STE.204, IRVINGTON, NJ 07111-3277
(973) 416-6981
(973) 375-5766
Mailing address
105 INDEPENDENCE DR, ROSELLE, NJ 07203-2410
(908) 245-3637
(973) 375-5766
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
Primary
25MA07986300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0098256
—
NJ
Enumeration date
09/27/2006
Last updated
07/08/2007
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