# PHILIP A. BONANNO, M.D. P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932210002
- **Authorized official:** PHILIP A. BONANNO M.D., P.C. (OPHTHALMOLOGIST)
- **Authorized official phone:** (516) 671-5676

## Contact information

- **Practice address:** 70 GLEN ST, SUITE 380, GLEN COVE, NY 11542-2855
- **Practice address phone:** (516) 671-5676
- **Practice address fax:** (516) 671-6893
- **Mailing address:** 70 GLEN ST, SUITE 380, GLEN COVE, NY 11542-2855
- **Mailing address phone:** (516) 671-5676
- **Mailing address fax:** (516) 671-6893

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 124617 | NY | Yes |

## Other

- **Enumeration date:** 08/31/2006
- **Last updated:** 07/31/2014