Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MARK JOSEPH BANNON, OD
Active Sole ProprietorDR. MARK JOSEPH BANNON, OD is a Eyewear Supplier healthcare provider located in KENSINGTON, Connecticut. NPI 1558417949 is currently active in the NPPES registry. Verify at CMS.
Eyewear Supplier · KENSINGTON, CT
Registration Details
- NPI Number
- 1558417949
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 26, 2007 (19.521136435077 yrs)
- Last Updated
- Nov 3, 2008
- Licenses
-
888 (CT)888 (CT)
- Sole Proprietor
- Yes
Practice Information
- Address
-
359 MAIN STKENSINGTON, CT, 060372651Browse CT providers · Browse ZIP 06037
- Phone
- 8608291020
- Fax
- 8608285246
- Primary Specialty
-
Eyewear Supplier
332H00000X
- Additional Specialty
- Eyewear Supplier
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.