Gabriel D Banschick, MD
Individual provider Active NPI Psychiatry Physician · Hartford, CT
NPI 1336729698 · NPPES record last updated Nov 6, 2024
Key facts
- NPI
- 1336729698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 079030 (CT)
- Practice address
- 200 Retreat Ave
Hartford, CT 06106-3309 - Phone
- (860) 545-7909
- NPI assigned
- Apr 12, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241112003467 | CT | Practitioner - Psychiatry | 3375077472 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 079030 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hartford Hospital | Current |
Accepting new patients | |
| Hartford Hospital | Psychiatry | Current |
Accepting new patients |
Locations
200 Retreat Ave
Hartford, CT 06106
Phone (860) 545-7000
1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Psychiatry Physician | 2084P0800X | 079030 | CT | Yes |
Addresses
Primary practice location
200 Retreat Ave
Hartford, CT 06106-3309
Mailing address
200 Retreat Ave
Hartford, CT 06106-3309
Phone (860) 545-7909
Other providers in Hartford, CT
- Michael Brian Banik
- Uttam K Banik
- Linda Banks
- Robert Kevin Banks
- Anu Bansal
- John V Banta Sr.
- Shanshan Bao
- Kaveh Barami
- Lauren Barber
- Rachael Barber
All providers in Hartford, CT · Psychiatry Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.