Individual
BONNIE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2559
(718) 630-7185
Mailing address
PO BOX 409041, ATLANTA, GA 30384-9041
(800) 377-8721
(304) 523-2241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
155805-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01274042
—
NY
01
—
1393Q1
BLUECROSS BLUESHIELD
NY
01
—
P00333354
RAILROAD
NY
Enumeration date
03/17/2006
Last updated
10/24/2007
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