Mary Jacqueline Banning, PT
Individual provider Active NPI Physical Therapist · Southbury, CT
NPI 1386115681 · NPPES record last updated Dec 12, 2018
Key facts
- NPI
- 1386115681
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 9495 (CT)
- Practice address
- 655 Main Sreet South
Southbury, CT 06488 - Phone
- (877) 407-3422
- Fax
- (877) 407-4329
- NPI assigned
- Dec 12, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9495 | CT | Yes |
Addresses
Primary practice location
655 Main Sreet South
Southbury, CT 06488
Mailing address
7 Carnegie PLZ
Cherry Hill, NJ 08003-1000
Phone (877) 407-3422
Other providers in Southbury, CT
- Amber Auger
- Stephanie L. Bakewell
- Lisa Baldelli
- Laura Baltzell
- Mandy Baniszewski
- Sarah Bannon
- Barbara a. Kilkenny, DPM
- Barbara a. Kilkenny, PC
- Barbell Physical Therapy and Performance, LLC
- Daniel James Barker
All providers in Southbury, CT · Physical Therapist in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 12, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.