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
Phone: (516) 671-5676
Fax:
Website:
Health care specialties
| Specialty | Code | License # | 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 12 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 | 1609867845 | NPPES |
| New York | MEDICAID | 00391873 |
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