Individual
DANIEL JOSEPH BANNEN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
2589 RAMONA ST, EAST MEADOW, NY 11554-5319
(516) 785-5416
Mailing address
2589 RAMONA ST., EAST MEADOW, NY 11554
(516) 785-5416
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
012191-1
NY
Other
Enumeration date
10/07/2008
Last updated
06/05/2023
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