Organization
BONNIE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BONNIE LEE FISHER-LOVERDE NURSE (LPN)
(585) 969-2965
Entity
Organization
Contact information
Practice address
122 MAIN ST N, PERRY, NY 14530-1217
(585) 969-2966
Mailing address
122 MAIN ST N, PERRY, NY 14530-1217
(585) 969-2966
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
142765-1
NY
311500000X
Alzheimer Center (Dementia Center)
142765-1
NY
311ZA0620X
Adult Care Home Facility
142765-1
NY
314000000X
Skilled Nursing Facility
Primary
142765-1
NY
315D00000X
Inpatient Hospice
142765
NY
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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