Bonilla, Jorge
Bonilla, Jorge is an sole proprietor health care provider with primary practice located at 191 W Hoffman Ave , Lindenhurst NY 11757-4036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bonilla, Jorge can be contacted via phone (631) 608-4741.Contact Information
Primary practice address
191 W Hoffman Ave
Lindenhurst NY 11757-4036
Phone: (631) 608-4741
Fax: (631) 608-4742
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 264692 | New York |
Profile Details
| NPI number | 1376834176 |
|---|---|
| LBN Legal business name | Bonilla, Jorge |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 27th, 2011 |
| Last updated | Aug 15th, 2023 - about 2 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 | 1376834176 | NPPES |
| New York | MEDICAID | 04343519 |
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