Provider Demographics
NPI:1124310065
Name:BANKER, SUMEET L (MD)
Entity type:Individual
Prefix:
First Name:SUMEET
Middle Name:L
Last Name:BANKER
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 1:622 W 168TH ST
Mailing Address - Street 2:VC 4TH FLOOR, ROOM 617
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-5918
Mailing Address - Fax:212-305-8482
Practice Address - Street 1:622 W 168TH ST
Practice Address - Street 2:VC 4TH FLOOR, ROOM 617
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3720
Practice Address - Country:US
Practice Address - Phone:212-305-5918
Practice Address - Fax:212-305-8482
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY280933-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics