Kenneth J Banasiak
Pediatric Critical Care Doctor
22 Bramhall St Pediatric Intensive Care
Portland
, Maine 04102
Kenneth J Banasiak
Pediatric Critical Care Doctor
22 Bramhall St Pediatric Intensive Care
Portland
, Maine 04102
(207) 396-8632
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About
Features
Specialties
- Pediatric Critical Care Doctor
Languages spoken
- English
Location
First Address
- Kenneth J Banasiak
- 301 Us Route 1 Building C
- Scarborough, ME
- Zip : 04074-7609
- Fax : (207) 396-8632
- Phone : (207) 396-8600
Second Address
- Kenneth J Banasiak
- 22 Bramhall St Pediatric Intensive Care
- Portland, ME
- Zip : 04102
- Fax : (207) 662-6326
- Phone : (207) 662-2179
Reviews
FAQs
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Is Kenneth J Banasiak a sole practitioner?
Is Kenneth J Banasiak accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0203X | Pediatric Critical Care Doctor | 017898 | ME |
| N | 2080P0203X | Pediatric Critical Care Doctor | 035451 | CT |
National Provider Identifier
| NPI | 1205818929 |
|---|---|
| Provider Name | Kenneth J Banasiak |
| First Address | Scarborough, ME 04074-7609 |
| Second Address | Portland, ME 04102 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/11/2005 |
| Last Update Date | 26/11/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 001354513 | (05) | CT |
| 30208101 | (05) | NH |
| 433063199 | (05) | ME |
| G34354 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.