Individual
MR. JOSE TADEO BONOAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
337 KIMBALL AVE, YONKERS, NY 10704-3032
(914) 338-7534
(914) 338-7537
Mailing address
PO BOX 351, DOBBS FERRY, NY 10522-0351
(914) 439-6590
(914) 478-1481
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
202436-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01788870
—
NY
Enumeration date
11/14/2005
Last updated
03/15/2010
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