Provider Demographics
NPI:1407394752
Name:BUONO, ROSEANNE
Entity Type:Individual
Prefix:
First Name:ROSEANNE
Middle Name:
Last Name:BUONO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:776 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-5622
Mailing Address - Country:US
Mailing Address - Phone:631-671-0234
Mailing Address - Fax:
Practice Address - Street 1:776 S 5TH ST
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-5622
Practice Address - Country:US
Practice Address - Phone:631-671-0234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist