Individual provider · Type 1 NPI

Lenore Bonanno, MS, PA

Medical Physician Assistant · Stony Brook, NY

NPI number 1750554515 Active

Practice location

Stony Brook University Cancer Ctr, 3 Edmund Pellegrino Rd
Stony Brook, NY 11794-8183

Fax (631) 444-8909

Mailing address

Stony Brook University Hospital 100 Nicolls Rd, Hsc T18-030
Stony Brook, NY 11794-8183

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XP63329 (NY)
Medical Physician Assistant Primary 363AM0700X013193 (NY)

Medical Physician Assistant: Definition to come...

4 other providers at this address

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About NPI 1750554515

Lenore Bonanno, MS, PA's National Provider Identifier is 1750554515, issued on Apr 11, 2008. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Stony Brook, NY. The record was last updated on Aug 28, 2017.