Individual
MR. ALFRED CLAYTON BANNERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8900 VAN WYCK EXPRESSWAY, JAMAICA, NY 11418-2832
(718) 206-7089
(718) 206-7055
Mailing address
180 SALEM ROAD, WESTBURY, NY 11590
(516) 997-3269
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
111142
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084255
—
AZ
05
—
14071762
—
CO
05
—
42551056
—
NM
Enumeration date
03/31/2006
Last updated
11/25/2014
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