Provider Demographics
NPI:1891144325
Name:JENNIFER L BONHEUR, MD, PLLC
Entity Type:Organization
Organization Name:JENNIFER L BONHEUR, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:BONHEUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-570-2075
Mailing Address - Street 1:1317 3RD AVE
Mailing Address - Street 2:FL 7
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-2995
Mailing Address - Country:US
Mailing Address - Phone:212-570-2075
Mailing Address - Fax:
Practice Address - Street 1:1317 3RD AVE
Practice Address - Street 2:FL 7
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-2995
Practice Address - Country:US
Practice Address - Phone:212-570-2075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty