Individual
BONNY ZUCKERBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 NEILSON ST, FAR ROCKAWAY, NY 11691-4720
(917) 692-6864
Mailing address
20 MERVIN ST, INWOOD, NY 11096-2014
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/19/2019
Last updated
05/24/2022
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