| Doctor Name: | DR. SAMUEL A BANIGO |
| NPI Number: | 1063503555 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D., |
| License Number: | 25MA07986300 |
| Business Practice Address: | 40 Union Ave Ste.204 Irvington, NJ - 071113277 |
| Business Phone Number: | 9734166981 |
| Business Fax Number: | 9733755766 |
| Mailing Address: | 105 Independence Dr, ROSELLE |
| State: | NJ |
| Postal Code: | 072032410 |
| Phone Number: | 9082453637 |
| Fax Number: | 9733755766 |
| NPI Enumeration Date: | 09/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RA0000X |
| License Number: | 25MA07986300 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | An internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |