Provider Demographics
NPI:1073097010
Name:BONAPARTE-GRAY, ERMA BERNELL (MSED)
Entity Type:Individual
Prefix:MS
First Name:ERMA
Middle Name:BERNELL
Last Name:BONAPARTE-GRAY
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11915 228TH ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-2133
Mailing Address - Country:US
Mailing Address - Phone:347-592-6904
Mailing Address - Fax:
Practice Address - Street 1:11915 228TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-2133
Practice Address - Country:US
Practice Address - Phone:347-592-6904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-15
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency