| Jorge Bonilla Md Pc | |
|
191 W Hoffman Ave Lindenhurst NY 11757-4036 | |
| (631) 608-4741 | |
| (631) 608-4742 |
| Full Name | Jorge Bonilla Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 191 W Hoffman Ave, Lindenhurst, New York |
| Authorized Official Name and Position | Jorge Bonilla (MD) |
| Authorized Official Contact | 6316084741 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jorge Bonilla Md Pc 116 Broadway Ste 1 Amityville NY 11701-2797 Ph: (631) 608-4741 | Jorge Bonilla Md Pc 191 W Hoffman Ave Lindenhurst NY 11757-4036 Ph: (631) 608-4741 |
| NPI Number | 1669038329 |
|---|---|
| Provider Enumeration Date | 05/17/2019 |
| Last Update Date | 08/15/2023 |
| Medicare PECOS PAC ID | 5496088288 |
|---|---|
| Medicare Enrollment ID | O20190611000263 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669038329 | NPI | - | NPPES |
| 264692 | Other | NY | LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jorge L Bonilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376834176 PECOS PAC ID: 5890963318 Enrollment ID: I20160401001309 |
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