Provider Demographics
NPI:1225540511
Name:BANERJIE, PIYALI SMRITI
Entity Type:Individual
Prefix:
First Name:PIYALI
Middle Name:SMRITI
Last Name:BANERJIE
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 1:3001 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2305
Mailing Address - Country:US
Mailing Address - Phone:330-313-9287
Mailing Address - Fax:
Practice Address - Street 1:2500 18TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2109
Practice Address - Country:US
Practice Address - Phone:415-546-6756
Practice Address - Fax:415-546-6756
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-26
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker