Bonasera, Gregory N.
Bonasera, Gregory N. is an sole proprietor health care provider with primary practice located at 1041 Route 112 , Port Jefferson Station NY 11776-6000. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Bonasera, Gregory N. can be contacted via phone (631) 828-4545.Contact Information
Primary practice address
1041 Route 112
Port Jefferson Station NY 11776-6000
Phone: (631) 828-4545
Fax: (631) 642-1070
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | X005301 | New York |
Profile Details
| NPI number | 1841374352 |
|---|---|
| LBN Legal business name | Bonasera, Gregory N. |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 24th, 2006 |
| Last updated | Nov 14th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1841374352 | NPPES |
| New York | MEDICAID | 01738361 |
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