Antolin, Eleanor Banzon

Antolin, Eleanor Banzon is an sole proprietor health care provider with primary practice located at 206 E Brown St , East Stroudsburg PA 18301-3006. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Antolin, Eleanor Banzon can be contacted via phone (570) 421-4000.

Contact Information

Primary practice address
206 E Brown St East Stroudsburg PA 18301-3006
Phone: (570) 421-4000
Fax: (570) 424-3346
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD-061175-L Pennsylvania

Profile Details

NPI number 1285846071
LBN Legal business name Antolin, Eleanor Banzon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 4th, 2007
Last updated Apr 1st, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285846071 NPPES
Pennsylvania MEDICAID 017179400003
Pennsylvania MEDICAID 017179400002

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