Provider Demographics
NPI:1780823419
Name:BANIK, RUDRANI (MD)
Entity Type:Individual
Prefix:DR
First Name:RUDRANI
Middle Name:
Last Name:BANIK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 E 14TH ST
Mailing Address - Street 2:SUITE 319 SOUTH
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4201
Mailing Address - Country:US
Mailing Address - Phone:212-979-4500
Mailing Address - Fax:212-979-4512
Practice Address - Street 1:310 E 14TH ST
Practice Address - Street 2:SUITE 319 SOUTH
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4201
Practice Address - Country:US
Practice Address - Phone:212-979-4500
Practice Address - Fax:212-979-4512
Is Sole Proprietor?:No
Enumeration Date:2009-02-19
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225415207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology