Provider Demographics
NPI:1871946954
Name:BANEK, ANN
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:BANEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9214 REDMONT RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6815
Mailing Address - Country:US
Mailing Address - Phone:505-379-8699
Mailing Address - Fax:
Practice Address - Street 1:9214 REDMONT RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6815
Practice Address - Country:US
Practice Address - Phone:505-379-8699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other