| Prof Nancy Cantey Banasiak, APRN, BC | |
| 
					789 Howard Ave, New Haven, CT 06519-1304  | |
| (203) 737-2417 | |
| (203) 785-6455 | 
| Full Name | Prof Nancy Cantey Banasiak | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Pediatrics | 
| Location | 789 Howard Ave, New Haven, Connecticut | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1386770337 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | 000926 (Connecticut) | Primary | 
| Entity Name | Yale University | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1205822236 PECOS PAC ID: 9436061736 Enrollment ID: O20031105000015  | 
| Entity Name | Child And Family Agency Of Southeastern Connecticut, Inc. | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1225797921 PECOS PAC ID: 2163756982 Enrollment ID: O20220426001904  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Prof Nancy Cantey Banasiak, APRN, BC 66 Quail Run, Madison, CT 06443-1900 Ph: (203) 737-2417  | Prof Nancy Cantey Banasiak, APRN, BC 789 Howard Ave, New Haven, CT 06519-1304 Ph: (203) 737-2417  | 
Audrey P Senior, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-5860 Fax: 203-688-7533  | |
Ashley Antonucci, DNP- FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Long Wharf Dr, New Haven, CT 06511 Phone: 203-688-8800  | |
Bailey Daum,  Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 40 Trumbull St, New Haven, CT 06510 Phone: 646-270-4857  | |
Kentrone Vines, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-4242  | |
Mrs. Lisa Jane Warren, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-7952  | |
Mrs. Rocca L Perruccio, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 428 Columbus Ave, New Haven, CT 06519 Phone: 203-503-3000 Fax: 203-503-3224  | |
Alexa Blood, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 800 Howard Ave, New Haven, CT 06519 Phone: 203-785-2565  |