Provider Demographics
NPI:1457697948
Name:BONNICK, SONYA L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SONYA
Middle Name:L
Last Name:BONNICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1429 BROADWAY
Mailing Address - Street 2:APT 3F
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1331
Mailing Address - Country:US
Mailing Address - Phone:516-569-1604
Mailing Address - Fax:
Practice Address - Street 1:1429 BROADWAY
Practice Address - Street 2:APT 3F
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1331
Practice Address - Country:US
Practice Address - Phone:516-569-1604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312915164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse