Individual
CAROL ELIZABETH BONURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Mailing address
118 NORTH COUNTRY ROAD, PORT JEFFERSON, NY 11777
(631) 473-7171
(631) 473-4605
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F390043
NY
363LP1700X
Perinatal Nurse Practitioner
F390043
NY
Other
Enumeration date
01/05/2007
Last updated
08/08/2007
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