Vader, Bonnie

Vader, Bonnie is an sole proprietor health care provider with primary practice located at 621 Amboy St Apt 1, Brooklyn NY 11212-4724. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Vader, Bonnie can be contacted via phone (718) 345-2935.

Contact Information

Primary practice address
621 Amboy St Apt 1 Brooklyn NY 11212-4724
Phone: (718) 345-2935
Fax: (718) 345-2940
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N004730 New York

Profile Details

NPI number 1285639294
LBN Legal business name Vader, Bonnie
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2005
Last updated Dec 27th, 2016 - about 10 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 1285639294 NPPES
New York MEDICAID 01247630
New York Other 36966P
New York Other N004730-A41
New York Other 6200135
New York Other KS581

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