Provider Demographics
NPI:1720417017
Name:MARCHIONE, BONNIE (LMT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:MARCHIONE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 VETERANS HWY
Mailing Address - Street 2:STE 210
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-2329
Mailing Address - Country:US
Mailing Address - Phone:631-366-4474
Mailing Address - Fax:631-366-4473
Practice Address - Street 1:740 VETERANS HWY
Practice Address - Street 2:STE 210
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-2329
Practice Address - Country:US
Practice Address - Phone:631-366-4474
Practice Address - Fax:631-366-4473
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027301-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist