Susan Banco's National Provider Identifier (NPI) Details
Susan Banco, LCSW
NPI: 1962035204
Enumeration Date: 2020-02-14
Last updated: 2020-02-14
Sole Proprietor: YES
Status: active
Postal Address: 286 CARRIAGE HOUSE DRIVE, JERICHO, NY
Phone: 516-805-6852
Primary Practice Address: 286 CARRIAGE HOUSE DRIVE, JERICHO, NY
Practice's phone: 516-805-6852