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Individual

MRS. KATHERINE MARIE BANGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
82 NEW PARK AVE, NORTH FRANKLIN, CT 06254-1807
(860) 889-7345
(860) 885-7228
Mailing address
82 NEW PARK AVE, NORTH FRANKLIN, CT 06254-1807
(860) 885-7223
(860) 885-7228

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA01107
RI
363AS0400X
Surgical Physician Assistant
002811
CT
363AS0400X
Surgical Physician Assistant
Primary
PA01107
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002811
LICENSE
CT
01
PA01107
LICENSE
RI
Enumeration date
10/17/2012
Last updated
11/26/2019
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