Individual
JOHN ANTHONY BONAVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 1ST AVE, NYU LANGONE MEDICAL CENTER, DEPARTMENT OF RADIOLOGY, NEW YORK, NY 10016-6402
(212) 263-5229
(212) 263-7348
Mailing address
550 1ST AVE, NYU LANGONE MEDICAL CENTER, DEPARTMENT OF RADIOLOGY, NEW YORK, NY 10016-6402
(212) 263-5229
(212) 263-7348
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
235647
NY
2085R0202X
Diagnostic Radiology Physician
MD015244E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0695428
—
PA
Enumeration date
07/26/2005
Last updated
07/24/2012
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