Individual
DR. GREGG ALLEN BANNETT
Active
Individual
DR. GREGG ALLEN BANNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MB04846500
NJ
207W00000X
Ophthalmology Physician
Primary
25MB04846500
NJ
Other
Enumeration date
08/05/2006
Last updated
09/02/2021
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