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Individual

UTTAM K BANIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-4088
(860) 714-8263
Mailing address
114 WOODLAND ST, HARTFORD, CT 06105-1208
(860) 714-4088
(860) 714-8263

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001766
CT
363A00000X
Physician Assistant
010020
NY

Other

Enumeration date
06/10/2006
Last updated
09/10/2013
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