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Organization

ALI BANKI, D.O., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALI BANKI D.O. (OWNER/PRESIDENT)
(860) 659-2779
Entity
Organization

Contact information

Practice address
15 CONCORD ST, GLASTONBURY, CT 06033-2135
(860) 659-2779
(860) 633-9315
Mailing address
15 CONCORD ST, GLASTONBURY, CT 06033-2135
(860) 659-2779
(860) 633-9315

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
048744
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
040048744CT01
ANTHEM BLUE CROSS/BLUE SHIELD
CT
01
048744
CONNECTICARE, INC.
CT
01
6426153
AETNA
CT
01
P4181742
OXFORD
CT
Enumeration date
02/01/2011
Last updated
02/01/2011
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