Individual
MR. PATRICK BONACUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
452 SUFFOLK AVE, BRENTWOOD, NY 11717-4214
(631) 436-6065
Mailing address
452 SUFFOLK AVE, BRENTWOOD, NY 11717-4214
(631) 436-6065
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
07/29/2025
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