Individual
LAUREN SUMMER BANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1800 ORLEANS ST, BALTIMORE, MD 21287-0010
(410) 955-8893
Mailing address
6201 GREENLEIGH AVE FL 2, MIDDLE RIVER, MD 21220-2004
(410) 933-2704
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
027165
NY
363A00000X
Physician Assistant
Primary
C0009251
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027165
NYS LICENSE
NY
Enumeration date
07/12/2021
Last updated
07/28/2025
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