Basic Information
| Provider Information | |||||||||
| NPI: | 1316383672 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PANER-BANSI | ||||||||
| FirstName: | JENINE | ||||||||
| MiddleName: | MARIE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | PANER | ||||||||
| OtherFirstName: | JENINE | ||||||||
| OtherMiddleName: | MARIE | ||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | D.O. | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 951 NIAGARA ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142132116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168840700 | ||||||||
| FaxNumber: | 7168840631 | ||||||||
| Practice Location | |||||||||
| Address1: | 951 NIAGARA ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142132116 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168840700 | ||||||||
| FaxNumber: | 7168840631 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2013 | ||||||||
| LastUpdateDate: | 04/09/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | DO2093 | NV | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 292396 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.