Provider Demographics
NPI:1346308418
Name:BANKO, TED (DC)
Entity Type:Individual
Prefix:DR
First Name:TED
Middle Name:
Last Name:BANKO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3615 NICHOLAS ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-5113
Mailing Address - Country:US
Mailing Address - Phone:610-252-2216
Mailing Address - Fax:610-252-5597
Practice Address - Street 1:3615 NICHOLAS ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5113
Practice Address - Country:US
Practice Address - Phone:610-252-2216
Practice Address - Fax:610-252-5597
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC001707L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor