Dr. Anthony Bonanno, M.D.
Anesthesiology in Smithtown, NY. Individual provider (NPI-1).
NPI number1174615751
StatusActive
Last updated in NPPESJan 28, 2011
Details
- NPI
- 1174615751
- Entity type
- Individual (NPI-1)
- Name
- Dr. Anthony Bonanno
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 29, 2006
- Last updated
- Jan 28, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207L00000X | Anesthesiology | 167355 | NY | Yes |
| 207LC0200X | Anesthesiology, Critical Care Medicine | 167355-1 | NY |
Practice location
50 Route 25aSmithtown, NY 11787
Phone 631-862-3413 · Fax 631-862-3604
Mailing address
50 Route 25aEmployee Services Building
Smithtown, NY 11787
Phone 631-862-3413 · Fax 631-862-3604
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