Provider Demographics
NPI:1942439765
Name:BONDAREVSKY, ERNESTO (MD 207R00000X)
Entity Type:Individual
Prefix:DR
First Name:ERNESTO
Middle Name:
Last Name:BONDAREVSKY
Suffix:
Gender:M
Credentials:MD 207R00000X
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 KEREN HAYESOD ST.
Mailing Address - Street 2:
Mailing Address - City:RAMAT HASHARON
Mailing Address - State:NOT EXISTENT
Mailing Address - Zip Code:47248
Mailing Address - Country:IL
Mailing Address - Phone:9723-549-0442
Mailing Address - Fax:9723-549-0517
Practice Address - Street 1:43 KEREN HAYESOD ST.
Practice Address - Street 2:
Practice Address - City:RAMAT HASHARON
Practice Address - State:NOT EXISTENT
Practice Address - Zip Code:47248
Practice Address - Country:IL
Practice Address - Phone:9723-549-0442
Practice Address - Fax:9723-549-0517
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4767207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease