Healthcare Provider Details

I. General information

NPI: 1295939676
Provider Name (Legal Business Name): JOSHUA BONSELL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4604 31ST AVE
ASTORIA NY
11103-1842
US

IV. Provider business mailing address

430 E 86TH ST APT 8C
NEW YORK NY
10028-6436
US

V. Phone/Fax

Practice location:
  • Phone: 718-545-5034
  • Fax:
Mailing address:
  • Phone: 917-273-3564
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25MA08205000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number235247
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: