Provider Demographics
NPI:1134096530
Name:BONORI, NAZIA
Entity type:Individual
Prefix:
First Name:NAZIA
Middle Name:
Last Name:BONORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 MAGLIE DR
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-5835
Mailing Address - Country:US
Mailing Address - Phone:929-231-9253
Mailing Address - Fax:
Practice Address - Street 1:25 MAGLIE DR
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-5835
Practice Address - Country:US
Practice Address - Phone:929-231-9253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty