Philip a. Bonanno, M.D. P.C.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

124617 Issued in NY

Legal business name

PHILIP A. BONANNO, M.D. P.C.

Practice address

70 Glen St
Suite 380
Glen Cove, NY 11542-2855

Phone

(516) 671-5676

Fax

(516) 671-6893

NPI assigned

Aug 31, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Philip A. Bonanno, M.D., P.C.

Title

Ophthalmologist

Phone

(516) 671-5676

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406764800000",
    "number": "1932210002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422855",
            "telephone_number": "516-671-5676",
            "fax_number": "516-671-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLEN ST",
            "address_2": "SUITE 380",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422855",
            "telephone_number": "516-671-5676",
            "fax_number": "516-671-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILIP A. BONANNO, M.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2014-07-31",
        "status": "A",
        "authorized_official_last_name": "BONANNO",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OPHTHALMOLOGIST",
        "authorized_official_telephone_number": "516-671-5676",
        "authorized_official_credential": "M.D., P.C."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "124617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00391873",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Pellerito, MHC
• Performance Home Care Physical Therapy PC
• Herbert S. Perry, M.D.
• Peter J. Kurzweil, M.D., P.C.
• Michele Jo Petherick, P.T.
• Reed E Phillips, M.D.
• Susan Lee Phillips, RD
• Physical Therapy Rehab@Home PC
• Nicole Pichardo, RN
• Zirza A. Pierri, D.D.S.

• Ophthalmology Physician in Glen Cove, NY
• Providers in Glen Cove, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.