Individual
DEBA BANERJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4771 HYLAN BLVD, STATEN ISLAND, NY 10312-6315
(718) 948-8200
(718) 948-8433
Mailing address
2791 RICHMOND AVE, 2ND FLOOR, STATEN ISLAND, NY 10314-5859
(718) 816-6440
(718) 948-8433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
192748
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01724285
—
NY
Enumeration date
03/29/2006
Last updated
11/12/2012
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