Provider Demographics
NPI:1437028412
Name:BONNE VIE FAMILY MEDICINE P.C
Entity type:Organization
Organization Name:BONNE VIE FAMILY MEDICINE P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-637-7464
Mailing Address - Street 1:2331 ROUTE 17
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-2816
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2331 ROUTE 17
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-2816
Practice Address - Country:US
Practice Address - Phone:845-637-7464
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-30
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty