Individual
AMY Q BANAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
26 HALIDAY ST, CLARK, NJ 07066-1833
(201) 486-5795
Mailing address
26 HALIDAY ST, CLARK, NJ 07066-1833
(201) 486-5795
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
40QA01173600
NJ
Other
Enumeration date
06/18/2007
Last updated
10/05/2009
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