Bonanno, Anthony

Bonanno, Anthony is an individual health care provider with primary practice located at 50 Route 25A , Smithtown NY 11787. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Critical Care Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Bonanno, Anthony can be contacted via phone (631) 862-3413.

Contact Information

Primary practice address
50 Route 25A Smithtown NY 11787
Fax: (631) 862-3604
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 167355 New York
Allopathic & Osteopathic Physicians / Critical Care Medicine 207LC0200X 167355-1 New York

Profile Details

NPI number 1174615751
LBN Legal business name Bonanno, Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Jan 28th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174615751 NPPES
New York MEDICAID 01067216

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