Provider Demographics
NPI:1316383672
Name:PANER-BANSI, JENINE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:JENINE
Middle Name:MARIE
Last Name:PANER-BANSI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JENINE
Other - Middle Name:MARIE
Other - Last Name:PANER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:951 NIAGARA ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-2116
Mailing Address - Country:US
Mailing Address - Phone:716-884-0700
Mailing Address - Fax:716-884-0631
Practice Address - Street 1:951 NIAGARA ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-2116
Practice Address - Country:US
Practice Address - Phone:716-884-0700
Practice Address - Fax:716-884-0631
Is Sole Proprietor?:No
Enumeration Date:2013-05-14
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO2093207Q00000X
NY292396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine