Healthcare Provider Details

I. General information

NPI: 1063463479
Provider Name (Legal Business Name): BONNEY GULINO SCHAUB M.S., A.P.R.N., B.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 MURRAY CT
HUNTINGTON NY
11743-3647
US

IV. Provider business mailing address

2 MURRAY CT
HUNTINGTON NY
11743-3647
US

V. Phone/Fax

Practice location:
  • Phone: 631-673-0293
  • Fax:
Mailing address:
  • Phone: 631-673-0293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License Number283081-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: