Individual
JONATHAN JOSEPH BANIBENSU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1450 CHAPEL ST, NEW HAVEN, CT 06511-4405
(203) 789-3000
Mailing address
90A HOWE ST, NEW HAVEN, CT 06511-4607
(120) 382-4807
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0010890
DE
Other
Enumeration date
09/30/2008
Last updated
01/23/2019
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