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Individual

ELAINE K BONOAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
20 YORK ST CB-2041, YNH MEDICAL SERVICES PC, NEW HAVEN, CT 06504
(203) 688-4748
(203) 688-4740
Mailing address
20 YORK ST, CB-2041, NEW HAVEN, CT 06504-8900
(203) 688-4748
(203) 688-4740

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
000894
CT
363AM0700X
Medical Physician Assistant
Primary
000894
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000894
PA-C LICENSE
CT
01
029227
CONTROLLED SUBSTANCE LIC
CT
Enumeration date
09/28/2006
Last updated
03/07/2023
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