Individual provider · Type 1 NPI

John Mark Carlos Bonagua, AGNP

Adult Health Nurse Practitioner · Bronx, NY

NPI number 1477077535 Active

Practice location

612 Allerton Ave
Bronx, NY 10467-7404

Call (718) 519-4029 Map

Mailing address

612 Allerton Avenue
Bronx, NY 10467

Specialties and licenses

Taxonomy	Code	License
Adult Health Nurse Practitioner Primary	363LA2200X	308120 (NY)

Adult Health Nurse Practitioner: Definition to come...

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About NPI 1477077535

John Mark Carlos Bonagua, AGNP's National Provider Identifier is 1477077535, issued on Jul 31, 2017. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Bronx, NY. The record was last updated on Sep 11, 2017.