Individual
NICHOLAS BANKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
521 5TH AVE, NEW YORK, NY 10175-0003
(914) 740-5287
Mailing address
173D EDGEWATER PARK, BRONX, NY 10465-3514
(347) 541-2388
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
F402473
NY
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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