Provider Demographics
NPI:1659453504
Name:BONET-PAGAN, YARA A (MD)
Entity Type:Individual
Prefix:DR
First Name:YARA
Middle Name:A
Last Name:BONET-PAGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 BRONX BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470
Mailing Address - Country:US
Mailing Address - Phone:718-304-7000
Mailing Address - Fax:
Practice Address - Street 1:4401 BRONX BOULEVARD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470
Practice Address - Country:US
Practice Address - Phone:718-304-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16511208D00000X
NY2795822084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice