Provider Demographics
NPI:1598044380
Name:BONDARENKA, DAVID KRISTOFOR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KRISTOFOR
Last Name:BONDARENKA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 N FRONT ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3832
Mailing Address - Country:US
Mailing Address - Phone:845-338-8000
Mailing Address - Fax:
Practice Address - Street 1:86 N FRONT ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3832
Practice Address - Country:US
Practice Address - Phone:845-338-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053225183500000X
CT0011170183500000X
SC12821183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist