Bonanno, Philip

Bonanno, Philip is an sole proprietor health care provider with primary practice located at 70 Glen St Ste 380 , Glen Cove NY 11542-2858. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bonanno, Philip can be contacted via phone (516) 671-5676.

Contact Information

Primary practice address
70 Glen St Ste 380 Glen Cove NY 11542-2858
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 124617 New York

Profile Details

NPI number 1609867845
LBN Legal business name Bonanno, Philip
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2005
Last updated Jul 31st, 2014 - about 10 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 1609867845 NPPES
New York MEDICAID 00391873

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