Individual
BONNIE PANEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
127 E STATE STREET, GKLOVERSVILLE, NY 12078-1204
(518) 773-7931
Mailing address
PO BOX 80, CAROGA LAKE, NY 12032
(518) 835-2413
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
466683-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PANEK12099
OTHER
NY
Enumeration date
12/06/2016
Last updated
12/06/2016
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