Individual
MR. BONNY YOHANNAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(516) 643-8277
Mailing address
7925 WINCHESTER BLVD, QUEENS VILLAGE, NY 11427-2128
(719) 264-4050
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
730248
NY
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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