Individual
MRS. BONNIE RENEE GILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD, CDN, CDE
Contact information
Practice address
383 PLYMOUTH ST, WEST HEMPSTEAD, NY 11552-2450
(516) 486-4569
(516) 486-1792
Mailing address
383 PLYMOUTH ST, WEST HEMPSTEAD, NY 11552-2450
(516) 486-4569
(516) 486-1792
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
000251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100114175001
UNITEDHEALTHCARE MEDICAID
NY
01
—
1141750
UNITED HEALTHCARE
NY
01
—
205253P
HIP
NY
01
—
2142444
VYTRA HEALTH PLANS
NY
01
—
8000066
GHI
NY
01
—
8461009
CIGNA HEALTHCARE
NY
01
—
P797526
OXFORD HEALTH PLANS
NY
Enumeration date
04/17/2007
Last updated
07/08/2007
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