NPI 1689157471

Tageldin Banaga

Practitioner Driver Bridgeport, CT

Practice location

Address: 1333 E Main St APT 5, Bridgeport, CT 06608-1400
Phone: (203) 543-3819

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 017671860 (CT)

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Registry record

NPI: 1689157471
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Sep 2018
Record last updated: 8 Sep 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.