Provider Demographics
NPI:1639867906
Name:BANERJEE, BRIANNA Y (PA-C)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:Y
Last Name:BANERJEE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7780 BRIER CREEK PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7869
Mailing Address - Country:US
Mailing Address - Phone:919-596-3400
Mailing Address - Fax:919-596-3499
Practice Address - Street 1:7780 BRIER CREEK PKWY STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7869
Practice Address - Country:US
Practice Address - Phone:919-596-3400
Practice Address - Fax:919-596-3499
Is Sole Proprietor?:No
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001013179363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical