Vincent R Bonagura

MD | Pediatric Allergy-Immunology | Male

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Complete Profile:

Vincent R Bonagura basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Allergy/Immunology
Provider Name :	Vincent R Bonagura
Credential :	MD
Gender :	Male
Sole Proprietor :	Yes

Business Address:

Vincent R Bonagura address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	865 Northern Blvd, Suite 101 Great Neck, NY, 11021-5310 United States
Phone Number :	516-622-5070
Fax Number :	516-622-5060

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1568556629
NPI Entity Type :	Individual
First Enrolment Date :	03 Oct, 2006
Last Updated On :	08 Jul, 2007

Medicare Participation:

Vincent R Bonagura participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	7012992134
Medicare Enrollment ID :	I20040622001732
Primary Specialty :	Pediatric Medicine
Medical School :	Columbia University College Of Physicians And Surgeons
Graduation Year :	1974
Accepts Medicare?	Yes. Vincent R Bonagura accepts medicare insurance.

Group Practice Association:

Vincent R Bonagura is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Vincent R Bonagura is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
North Shore - Lij Medical Pc	3375701568	4824	865 Northern Blvd Great Neck, NY - 110215310 Ph: 5166225070	Yes
North Shore - Lij Medical Pc	3375701568	4824	865 Northern Boulevard Great Neck, NY - 110215310	Yes
North Shore - Lij Medical Pc	3375701568	4824	300 Community Dr Manhasset, NY - 110303816	Yes
North Shore - Lij Medical Pc	3375701568	4824	300 Community Dr Ll Manhasset, NY - 110303816 Ph: 5165622229	Yes
North Shore - Lij Medical Pc	3375701568	4824	330 Community Dr Manhasset, NY - 110303816 Ph: 5167082550	Yes
North Shore - Lij Medical Pc	3375701568	4824	350 Community Dr Manhasset, NY - 110303816 Ph: 5165623845	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Vincent R Bonagura are as mentioned. Primary taxonomy code for Vincent R Bonagura, MD is 2080P0201X (Pediatrics Pediatric Allergy/Immunology).

Taxonomy Code	Speciality	Primary	License No.	State
2080P0201X	Pediatrics Pediatric Allergy/Immunology	Yes	127269	NY

Legacy Identifiers:

Other legacy medical identifiers of Vincent R Bonagura such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.

Identifier	Identifier Type	State	Issuer
00828937	MEDICAID	NY

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	175 Community Dr, 2nd Floor Great Neck, NY, 11021-5502 United States
Phone Number :	516-465-1900
Fax Number :	516-465-1830

Business Location:

Patients can refer following map for directions to Vincent R Bonagura practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.