Individual
LAURA BETH BONACORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
14 GROVE ST, MIDDLETOWN, NY 10940
(845) 563-8000
Mailing address
2570 ROUTE 9W STE 10, CORNWALL, NY 12518-1370
(845) 220-3100
(845) 534-2940
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
702003
NY
363LP0200X
Pediatric Nurse Practitioner
Primary
F382626
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04549579
—
NY
Enumeration date
02/22/2008
Last updated
08/12/2020
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