Provider Demographics
NPI:1811409824
Name:BANKS, CATHERINE GAYE (MD)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:GAYE
Last Name:BANKS
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 1:243 CHARLES STREET
Mailing Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY - LEVEL 4
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:617-573-3653
Mailing Address - Fax:617-573-3939
Practice Address - Street 1:243 CHARLES STREET
Practice Address - Street 2:DEPARTMENT OF OTOLARYNGOLOGY - LEVEL 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114
Practice Address - Country:US
Practice Address - Phone:617-573-3653
Practice Address - Fax:617-573-3939
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2018-07-10
Deactivation Date:2018-07-02
Deactivation Code:
Reactivation Date:2018-07-10
Provider Licenses
StateLicense IDTaxonomies
ALL.4616207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology