Individual
DR. GERONIMO BANAYAT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
29 BROADWAY, CLARK, NJ 07066-2557
(732) 574-1887
Mailing address
29 BROADWAY, CLARK, NJ 07066-2557
(732) 574-1887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA51978
NJ
207RN0300X
Nephrology Physician
MA51978
NJ
Other
Enumeration date
11/01/2006
Last updated
02/25/2020
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