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Individual

ANTHONY J BONNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
565 ABBOTT RD, MERCY HOSPITAL, BUFFALO, NY 14220-2039
(716) 826-7000
(716) 213-0348
Mailing address
908 NIAGARA FALLS BLVD, STE 208, N TONAWANDA, NY 14120-2019
(716) 692-2160
(716) 213-0348

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
104128
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010019101
UNIVERA
NY
01
000506757003
BLUE CROSS TRADITIONAL CO
NY
05
1084844
NY
01
2100902
INDEPENDENT HEALTH
NY
Enumeration date
11/22/2005
Last updated
06/13/2008
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