Provider Demographics
NPI:1851673198
Name:BANAS, HALIE (PA)
Entity Type:Individual
Prefix:
First Name:HALIE
Middle Name:
Last Name:BANAS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:5500 BROOKTREE RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9260
Mailing Address - Country:US
Mailing Address - Phone:724-933-1420
Mailing Address - Fax:724-933-1439
Practice Address - Street 1:5500 BROOKTREE RD
Practice Address - Street 2:SUITE 201
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9260
Practice Address - Country:US
Practice Address - Phone:724-933-1420
Practice Address - Fax:724-933-1439
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-13
Last Update Date:2017-03-17
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Provider Licenses
StateLicense IDTaxonomies
PA363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant