Vincent R Bonagura
Pediatric Allergist
865 Northern Blvd Suite 101
Great Neck
, New York 11021-5310
Vincent R Bonagura
Pediatric Allergist
865 Northern Blvd Suite 101
Great Neck
, New York 11021-5310
(516) 465-1830
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About
Features
Specialties
- Pediatric Allergist
Languages spoken
- English
Location
First Address
- Vincent R Bonagura
- 175 Community Dr 2nd Floor
- Great Neck, NY
- Zip : 11021-5502
- Fax : (516) 465-1830
- Phone : (516) 465-1900
Second Address
- Vincent R Bonagura
- 865 Northern Blvd Suite 101
- Great Neck, NY
- Zip : 11021-5310
- Fax : (516) 622-5060
- Phone : (516) 622-5070
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Is Vincent R Bonagura a sole practitioner?
Is Vincent R Bonagura accepting new patients?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0201X | Pediatric Allergist | 127269 | NY |
National Provider Identifier
| NPI | 1568556629 |
|---|---|
| Provider Name | Vincent R Bonagura |
| First Address | Great Neck, NY 11021-5502 |
| Second Address | Great Neck, NY 11021-5310 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/10/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00828937 | (05) | NY |
| B17087 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.