Individual
BRANDON BONANNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 NICOLLS RD, HSC T12 RM 080, STONY BROOK, NY 11794-8122
(631) 444-1116
(631) 444-1535
Mailing address
2 WHITCOMB AVE, MOUNT SINAI, NY 11766-2229
(631) 339-1006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
05/26/2025
Last updated
09/04/2025
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