Provider Demographics
NPI:1952610701
Name:BONAWITZ-DODI, ANNEMARIE (MD)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:BONAWITZ-DODI
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 1:121 PIERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4513
Mailing Address - Country:US
Mailing Address - Phone:248-390-7407
Mailing Address - Fax:
Practice Address - Street 1:942 ROUTE 376 STE 201
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-6493
Practice Address - Country:US
Practice Address - Phone:845-765-2366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-28
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258734207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine