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Individual

DR. SANJOY BANIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 522-8641
Mailing address
955 N RESLER DR STE 104, EL PASO, TX 79912-1407

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD2016-0793
NM
2084P0800X
Psychiatry Physician
P0339
TX
2084P0804X
Child & Adolescent Psychiatry Physician
23762
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10025559200
NE
Enumeration date
12/27/2006
Last updated
07/27/2021
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