Provider Demographics
NPI:1699891549
Name:BANERJEE, CYRUS (BS)
Entity type:Individual
Prefix:MR
First Name:CYRUS
Middle Name:
Last Name:BANERJEE
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1306 SPRING GARDEN ST
Mailing Address - Street 2:LOWER LEVEL
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3213
Mailing Address - Country:US
Mailing Address - Phone:215-238-2150
Mailing Address - Fax:
Practice Address - Street 1:1306 SPRING GARDEN ST
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19123-3213
Practice Address - Country:US
Practice Address - Phone:215-238-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor