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:
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Health care specialties

SpecialtyCodeLicense #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 8 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 1841374352 NPPES
New York MEDICAID 01738361

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