Provider Demographics
NPI:1043537368
Name:BANTING, ANN BERNADETTE
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:BERNADETTE
Last Name:BANTING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SWAINTON GOSHEN RD
Mailing Address - Street 2:APARTMENT # 2
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-1456
Mailing Address - Country:US
Mailing Address - Phone:609-408-1972
Mailing Address - Fax:
Practice Address - Street 1:3 SWAINTON GOSHEN RD
Practice Address - Street 2:APARTMENT # 2
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1456
Practice Address - Country:US
Practice Address - Phone:609-408-1972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist