Dr Mark Joseph Bannon, OD is a
Eyewear Supplier based in Kensington, Connecticut. Dr Mark Joseph Bannon is licensed to practice in Connecticut (license number 888) and his current practice location is
359 Main St, Kensington, Connecticut. He can be reached at his office (for appointments etc.) via phone at
(860) 829-1020.
NPI number for Dr Mark Joseph Bannon is 1558417949 and his current mailing address is 359 Main St, Kensington, Connecticut. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1558417949.
Healthcare Provider's Profile
| Full Name | Dr Mark Joseph Bannon |
|---|
| Gender | Male |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 359 Main St, Kensington, Connecticut |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1558417949
- Provider Enumeration Date: 01/26/2007
- Last Update Date: 11/03/2008
Medical Identifiers
Medical identifiers for Dr Mark Joseph Bannon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558417949 | NPI | - | NPPES |
| 004101549 | Medicaid | CT | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 888 (Connecticut) | Secondary |
| 332H00000X | Eyewear Supplier | 888 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Joseph Bannon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mark Joseph Bannon, OD
359 Main St,
Kensington, CT 06037-2651
Ph: (860) 829-1020 | Dr Mark Joseph Bannon, OD
359 Main St,
Kensington, CT 06037-2651
Ph: (860) 829-1020 |
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