Individual
BANOUB MICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7487
Mailing address
300 STATION DR APT 316, AVENEL, NJ 07001-1794
(201) 201-9963
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/12/2021
Last updated
07/12/2021
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