Individual
MEGHAN BONOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 HEALTHY WAY, OCEANSIDE, NY 11572-1551
(516) 632-3000
Mailing address
20 GRACE AVE, LYNBROOK, NY 11563-1736
(516) 510-8442
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
430947
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
618401
NY
Other
Enumeration date
12/29/2015
Last updated
09/03/2019
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