| Banyan Integrative Health Llc | |
|
2802 N Alvernon Way Ste 200 Tucson AZ 85712-1500 | |
| (520) 326-0850 | |
| (520) 326-0849 |
| Full Name | Banyan Integrative Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2802 N Alvernon Way Ste 200, Tucson, Arizona |
| Authorized Official Name and Position | Ingrid E Patsch (PARTNER) |
| Authorized Official Contact | 5203260850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Banyan Integrative Health Llc 2802 N Alvernon Way Ste 200 Tucson AZ 85712-1500 Ph: (520) 326-0850 | Banyan Integrative Health Llc 2802 N Alvernon Way Ste 200 Tucson AZ 85712-1500 Ph: (520) 326-0850 |
| NPI Number | 1992262810 |
|---|---|
| Provider Enumeration Date | 02/27/2019 |
| Last Update Date | 02/27/2019 |
| Medicare PECOS PAC ID | 4587904594 |
|---|---|
| Medicare Enrollment ID | O20190328001522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992262810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jessie M Pettit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821232216 PECOS PAC ID: 3173673258 Enrollment ID: I20090611000147 |
| Provider Name | Leila Ali-akbarian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134307903 PECOS PAC ID: 4688720436 Enrollment ID: I20090918000350 |
| Provider Name | Ingrid E Patsch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184673279 PECOS PAC ID: 6204809882 Enrollment ID: I20180110002363 |
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