Individual
DR. BONNIE VADER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
621 AMBOY ST, APT 1, BROOKLYN, NY 11212-4724
(718) 345-2935
(718) 345-2940
Mailing address
36 ELDORADO BLVD, PLAINVIEW, NY 11803-4624
(516) 297-6522
(516) 827-1971
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004730
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01247630
—
NY
01
—
36966P
HIP
NY
01
—
6200135
GHI
NY
01
—
KS581
OXFORD HEALTH PLAN
NY
01
—
N004730-A41
HEALTH FIRST
NY
Enumeration date
06/16/2005
Last updated
12/27/2016
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