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Individual

DR. ROSALIE E BANASIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
12808 NORTH BLACK CANYON HIGHWAY, PHOENIX, AZ 85029
(602) 375-1155
(602) 866-9169
Mailing address
12808 NORTH BLACK CANYON HIGHWAY, PHOENIX, AZ 85029
(602) 375-1155
(602) 866-9169

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
15037
AZ

Other

Enumeration date
03/20/2007
Last updated
09/27/2011
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