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Individual

DR. BUBU BANINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD PHD

Contact information

Practice address
40 TEMPLE ST STE 1A, NEW HAVEN, CT 06510-2715
(203) 688-4242
Mailing address
40 TEMPLE ST STE 1A, NEW HAVEN, CT 06510-2715

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
330642
NY
208M00000X
Hospitalist Physician
57517
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
66395
CONNECTICUT PHYSICIAN LICENSE
CT
Enumeration date
01/30/2012
Last updated
07/16/2020
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