Basic Information
| Provider Information | |||||||||
| NPI: | 1851374870 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BANKER | ||||||||
| FirstName: | DIPAK | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 155 CRYSTAL RUN RD | ||||||||
| Address2: | |||||||||
| City: | MIDDLETOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109414028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8457036999 | ||||||||
| FaxNumber: | 8457036297 | ||||||||
| Practice Location | |||||||||
| Address1: | 48 NEW MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HAVERSTRAW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109271812 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8454293382 | ||||||||
| FaxNumber: | 8454292057 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/23/2005 | ||||||||
| LastUpdateDate: | 07/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 136434 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.