Bonanno, Richard Joseph
Bonanno, Richard Joseph is an sole proprietor health care provider with primary practice located at 1869 Brentwood Rd , Brentwood NY 11717-4625. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bonanno, Richard Joseph can be contacted via phone (631) 853-3458.Contact Information
Primary practice address
1869 Brentwood Rd
Brentwood NY 11717-4625
Phone: (631) 853-3458
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 118089 | New York |
Profile Details
| NPI number | 1750472528 |
|---|---|
| LBN Legal business name | Bonanno, Richard Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 27th, 2006 |
| Last updated | Nov 18th, 2008 - about 18 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 | 1750472528 | NPPES |
| New York | MEDICAID | 00352727 |
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