NPI 1730776550 · live from the CMS NPI Registry
Andrew R Banuskevich, PA
Physician Assistant in Lebanon, NH. National Provider Identifier 1730776550, active.
NPI record
| NPI | 1730776550 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | One Medical Center Dr, Lebanon, NH 03756 |
| Practice phone | 603-650-6040 |
| Enumerated | December 28, 2020 |
| Last updated | April 28, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant primary | 363A00000X | — (NH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.