Organization
BONNIE VADER, DPM, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BONNIE VADER DPM (PRESIDENT)
(718) 345-2935
Entity
Organization
Contact information
Practice address
621 AMBOY ST, SUITE 1, BROOKLYN, NY 11212-4724
(718) 345-2935
(718) 345-2940
Mailing address
60 RUBY LN, PLAINVIEW, NY 11803-3822
(516) 931-0430
(516) 827-1971
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004730
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1247630
—
NY
01
—
A100000081
GHI MEDICARE
NY
01
—
KS581
OXFORD
NY
Enumeration date
05/18/2007
Last updated
11/09/2012
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