Nafiseh Banaha

Primary specialty

Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X

License

14994 Issued in CT

Practice address

55 Park St
New Haven, CT 06511-5474

Phone

(203) 688-1111

NPI assigned

Oct 20, 2021

Last updated

Jan 31, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1634688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1164185732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PARK ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115474",
            "telephone_number": "203-688-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "39400 Paseo Padre Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "CA",
            "postal_code": "945382310",
            "country_code": "US",
            "telephone_number": "510-248-7579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANAHA",
        "first_name": "NAFISEH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-20",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "88722",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "CT",
            "license": "14994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Lloyd Balter, M.D.
• Patricia Anne Balter, PH.D.
• Nigel S Bamford, MD
• Nancy Banack, PT
• Trevor Banack, M.D.
• Christine M Banas, LCSW
• Nancy Cantey Banasiak, APRN, BC
• Julia Anne Bancroft, NP
• Matthew Band, PA-C
• Molly E Band, PA-C

• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in New Haven, CT
• Providers in New Haven, CT by specialty
• Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.