Individual
SRI RANGA BONAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 MEDICAL PARK DRIVE, POMONA, NY 10970
(845) 362-5600
(845) 362-5616
Mailing address
1 MEDICAL PARK DR, POMONA, NY 10970-3516
(845) 362-5600
(845) 362-5616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
251825
NY
207RN0300X
Nephrology Physician
Primary
251825
NY
Other
Enumeration date
11/16/2006
Last updated
12/26/2013
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