Provider Demographics
NPI:1215328117
Name:RONJAN, BONIJ
Entity type:Individual
Prefix:
First Name:BONIJ
Middle Name:
Last Name:RONJAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3728 75TH ST
Mailing Address - Street 2:APT #BR
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-6426
Mailing Address - Country:US
Mailing Address - Phone:718-701-2666
Mailing Address - Fax:
Practice Address - Street 1:3728 75TH ST
Practice Address - Street 2:APT #BR
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-6426
Practice Address - Country:US
Practice Address - Phone:718-701-2666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-12
Last Update Date:2015-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide