Fredericks, Bonita L

Fredericks, Bonita L is an sole proprietor health care provider with primary practice located at 1177 Sumner Rd , Darien Center NY 14040-9797. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Fredericks, Bonita L can be contacted via phone (585) 547-9367.

Contact Information

Primary practice address
1177 Sumner Rd Darien Center NY 14040-9797
Phone: (585) 547-9367
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 2677331 New York

Profile Details

NPI number 1518139021
LBN Legal business name Fredericks, Bonita L
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 25th, 2008
Last updated Mar 25th, 2008 - about 17 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 1518139021 NPPES
New York MEDICAID 02705966

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