Individual
DR. GREGG ALLEN BANNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 N BROAD ST, WOODBURY, NJ 08096-1795
(856) 853-5554
(856) 853-5650
Mailing address
620 N BROAD ST, WOODBURY, NJ 08096-1795
(856) 853-5554
(856) 853-5650
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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