Search › New York › 163WP0807X
Johvani Bantiles
NPI 1770332280 · on the registry since 2024
Practice
- Address
- 650 State St
Watertown, NY 13601 - Phone
- (315) 755-1251
- Fax
- (315) 291-6601
- Clinicians at this address
- 100
Additional practice sites
- 1 Chimney Point Dr, Ogdensburg, NY
Registry record
- Primary taxonomy
- 163WP0807X
163WP0807X
- Licence states on file
- NY
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-10-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York