Provider Demographics
NPI:1982851572
Name:BANACH, STANLEY FRANCIS (MD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:FRANCIS
Last Name:BANACH
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 1:5401 ABERDENE ST
Mailing Address - Street 2:
Mailing Address - City:CENTER VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:18034-9552
Mailing Address - Country:US
Mailing Address - Phone:510-282-2099
Mailing Address - Fax:
Practice Address - Street 1:5401 ABERDENE ST
Practice Address - Street 2:
Practice Address - City:CENTER VALLEY
Practice Address - State:PA
Practice Address - Zip Code:18034-9552
Practice Address - Country:US
Practice Address - Phone:610-282-2099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008008E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology