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ABDUL LATIF BANIRE PA-C

Individual Provider (NPI-1) Active

Physician Assistant

Provider Information

NPI Number
1003195306
Provider Type
Individual Provider (NPI-1)
Credentials
PA-C
Status
Active

Contact & Location

Address
85 N GRAND AVE, FORT THOMAS, KY, 410751793
Phone
(859) 572-3618
Fax
(859) 572-2366

Specialties & Taxonomies

Physician Assistant Primary License: KY #PA1650
Physician Assistant License: IN #PA1650

All Addresses

LOCATION

85 N GRAND AVE

FORT THOMAS, KY, 410751793

(859) 572-3618

MAILING

PO BOX 18667

ERLANGER, KY, 410180667

(859) 572-3617