Individual
DIMITRINA BANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
374 STOCKHOLM ST, C/O FACULTY PRACTICE MANAGEMENT- SUITE 1-37 NORTH, BROOKLYN, NY 11237-4006
(718) 963-6551
Mailing address
1800 ORLEANS ST, SHEIKH ZAYED TOWER ROOM 6118, BALTIMORE, MD 21287-0010
(914) 707-2138
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
013532
NY
363A00000X
Physician Assistant
055-0031522
VT
363AS0400X
Surgical Physician Assistant
C0004445
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03210226
—
NY
Enumeration date
10/22/2009
Last updated
11/08/2021
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