Provider Demographics
NPI:1386967974
Name:GONONSKY, DEBBIE E (RPH)
Entity type:Individual
Prefix:
First Name:DEBBIE
Middle Name:E
Last Name:GONONSKY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2325
Mailing Address - Country:US
Mailing Address - Phone:516-295-5136
Mailing Address - Fax:
Practice Address - Street 1:711B SEAGIRT AVE
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5730
Practice Address - Country:US
Practice Address - Phone:718-327-4300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist