Provider Demographics
NPI:1558337667
Name:BANK, DAVID EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:EUGENE
Last Name:BANK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:359 E MAIN ST
Mailing Address - Street 2:STE 4G
Mailing Address - City:MT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549
Mailing Address - Country:US
Mailing Address - Phone:914-241-3003
Mailing Address - Fax:914-241-1525
Practice Address - Street 1:359 E MAIN ST
Practice Address - Street 2:STE 4G
Practice Address - City:MT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549
Practice Address - Country:US
Practice Address - Phone:914-241-3003
Practice Address - Fax:914-241-1525
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY168036207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
15F101Medicare ID - Type Unspecified
D92076Medicare UPIN