| Imelda Cruz-banting, Md, Pc | |
|
108 Van Guilder Ave New Rochelle NY 10801-5406 | |
| (914) 712-3144 | |
| (718) 944-6266 |
| Full Name | Imelda Cruz-banting, Md, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 108 Van Guilder Ave, New Rochelle, New York |
| Authorized Official Name and Position | Imelda Mangahas Cruz-banting (OWNER) |
| Authorized Official Contact | 9147793710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Imelda Cruz-banting, Md, Pc 12 Apple Ct Eastchester NY 10709-5540 Ph: (914) 779-3710 | Imelda Cruz-banting, Md, Pc 108 Van Guilder Ave New Rochelle NY 10801-5406 Ph: (914) 712-3144 |
| NPI Number | 1467642140 |
|---|---|
| Provider Enumeration Date | 07/27/2007 |
| Last Update Date | 07/27/2007 |
| Medicare PECOS PAC ID | 1658260179 |
|---|---|
| Medicare Enrollment ID | O20090505000461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467642140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 212537 (New York) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | 212537 (New York) | Secondary |
| Provider Name | Imelda M Cruz-banting |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1760458137 PECOS PAC ID: 2668564923 Enrollment ID: I20070816000720 |
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