Organization
DR JOSEPH BONANNO PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH BONANNO D.O. (OWNER)
(718) 863-7925
Entity
Organization
Contact information
Practice address
3101 E TREMONT AVE, BRONX, NY 10461-5705
(718) 863-7925
(718) 863-8208
Mailing address
2217 SEYMOUR AVE, BRONX, NY 10469-5826
(718) 863-7925
(718) 863-8208
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
187793
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
187793
LICENSE
NY
Enumeration date
04/07/2008
Last updated
04/07/2008
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