Individual
DANA R BANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16 PONOCO ROAD, SUITE 317, DENVILLE, NJ 07834
(973) 627-2650
(973) 627-8383
Mailing address
16 PONOCO ROAD, SUITE 317, DENVILLE, NJ 07834
(973) 627-2650
(973) 627-8383
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA06257400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110120473
RAILROAD MEDICARE
NJ
01
—
3T3821
WELLCHOICE
—
01
—
526293
MEDICARE ID
NJ
05
—
6643809
—
NJ
01
—
IP226
OXFORD
NJ
Enumeration date
07/13/2006
Last updated
12/28/2009
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