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KENNETH BANNERMAN MD FACC
NPI 1619969623
Internal Medicine - Cardiovascular Disease in Bloomfield, NJ

Active since August 16, 2005
1310 BROAD ST, BLOOMFIELD, NJ 07003(973) 338-0800(973) 338-1140 Get Directions Write a Review

NPPES record last updated: July 12, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenneth Bannerman Md Facc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH BANNERMAN MD FACC (NPI 1619969623) is an individual cardiovascular disease provider in Bloomfield, New Jersey, licensed in New Jersey (66554) and active in the NPI registry since August 2005.

NPPES Registry Identity

NPI1619969623
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameKENNETH BANNERMANCredential: MD FACC
Location Address1310 BROAD STBloomfield, NJ 07003-3009
Mailing Address1310 Broad StBloomfield, NJ 07003-3009 · (973) 338-0800 · Fax (973) 338-1140
Phone(973) 338-0800
Fax(973) 338-1140
Sole ProprietorNo
Enumeration DateAugust 16, 2005
Last NPPES UpdateJuly 12, 2007
✔ NPI 1619969623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License✔ Licensed in NJ · 66554
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Also ListedInternal MedicineTaxonomy 207R00000X · License 66554 (NJ)
1310 BROAD ST, Bloomfield, NJ 07003
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Other Identifiers 2

Medicare ID-Type Unspecified444180PLE
Medicare UPINC54676

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CARL MICHAEL SPINELLI II DC
Chiropractor
1310 BROAD ST
BLOOMFIELD, NJ 07003
Essex County (973) 338-5577
JULIE THOMAS KIDANGAN DO
Family Medicine
1310 BROAD ST
BLOOMFIELD, NJ 07003
Essex County (973) 338-0935
DR. WANDA JANINA MIKULSKI MD
Family Medicine
1310 BROAD ST
BLOOMFIELD, NJ 07003
Essex County (973) 338-5660

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth Bannerman's NPI number?

The NPI number for Kenneth Bannerman is 1619969623. It was assigned to this individual provider in the NPPES registry on August 16, 2005.

Where is Kenneth Bannerman located?

Kenneth Bannerman practices at 1310 Broad St, Bloomfield, NJ 07003. The listed phone number is (973) 338-0800.

What is Kenneth Bannerman's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Kenneth Bannerman was last updated on July 12, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.