Provider Demographics
NPI:1356579460
Name:BANG, DAISY H (MD)
Entity type:Individual
Prefix:DR
First Name:DAISY
Middle Name:H
Last Name:BANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2 IVY BROOK RD STE 115
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6416
Mailing Address - Country:US
Mailing Address - Phone:203-954-0080
Mailing Address - Fax:203-954-0084
Practice Address - Street 1:2 IVY BROOK RD STE 115
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6416
Practice Address - Country:US
Practice Address - Phone:203-954-0080
Practice Address - Fax:203-954-0084
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA195213207R00000X
CT54070207RR0500X, 207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine