Individual
MR. EDWARD C BONK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Mailing address
1201 NOTT ST, SUITE 106, SCHENECTADY, NY 12308-2589
(518) 374-3123
(518) 374-9711
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
403605-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000494072001
BLUE SHIELD OF NENY
—
01
—
10002421
CDPHP
—
01
—
33588Y
FIDELIS MEDICARE
—
01
—
403605-1
TRICARE NORTH REGION
—
01
—
4123054
MVP
—
01
—
9691728
GHI
—
01
—
R6B57
EMPIRE BLUE CROSS
—
01
—
X00000
AMERICAN PROGRESSIVE TODA
—
Enumeration date
07/29/2005
Last updated
11/10/2010
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