Individual
MR. VALENTIN BONILLA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
160 WATER ST, 2420, NEW YORK, NY 10038-4922
(212) 256-2602
(212) 256-2609
Mailing address
23B COOPER PL, BRONX, NY 10475-2805
(917) 856-6274
(212) 256-2609
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
000569
NY
363AM0700X
Medical Physician Assistant
000569-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02994489
—
NY
Enumeration date
08/22/2008
Last updated
01/03/2019
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