Provider Demographics
NPI:1588772750
Name:COREY, BONNIE
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:
Last Name:COREY
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 1:246 SCHERER BLVD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010-1337
Mailing Address - Country:US
Mailing Address - Phone:516-328-2880
Mailing Address - Fax:516-328-2892
Practice Address - Street 1:246 SCHERER BLVD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1337
Practice Address - Country:US
Practice Address - Phone:516-328-2880
Practice Address - Fax:516-328-2892
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX97411Medicare PIN