Provider Demographics
NPI:1942306436
Name:BANNERJEE, JOSEPHINE F (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPHINE
Middle Name:F
Last Name:BANNERJEE
Suffix:
Gender:F
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:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11002-0540
Mailing Address - Country:US
Mailing Address - Phone:516-326-0700
Mailing Address - Fax:516-616-4581
Practice Address - Street 1:271 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-2146
Practice Address - Country:US
Practice Address - Phone:516-326-0700
Practice Address - Fax:516-616-4581
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY120066207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B19314Medicare UPIN