KENNETH J BANASIAK

HARTFORD, CT
NPI1205818929
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2080P0203X Pediatrics, Pediatric Critical Care Medicine
(Licence: ME  017898)
Additional Taxonomies2080P0203X Pediatrics, Pediatric Critical Care Medicine
(Licence: CT  035451)
Enumeration Date2005-11-17
Last Update Date2022-09-09
Business Address
KENNETH J BANASIAK MD
282 WASHINGTON ST
HARTFORD, CT 06106-3322
Phone number: 860-545-9850
Mailing Address
KENNETH J BANASIAK MD
301 US ROUTE 1 BUILDING C
SCARBOROUGH, ME 04074-7609
Phone number: 207-396-8600