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General NPI Number Information
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NPI Number | 1871602540
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Entity Type | Organization
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Legal Business Name | JOHN BUONOCORE DO PC
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 946 LITTLE EAST NECK RD
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City | WEST BABYLON
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State | NY
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Zip | 11704-4620
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Country | US
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Telephone | 631-422-0852
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Fax |
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Provider Business Mailing Address
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Address Line | 946 LITTLE EAST NECK RD
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City | WEST BABYLON
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State | NY
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Zip | 11704-4620
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Country | US
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Telephone | 631-422-0852
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | JOHN ANTHONY BUONOCORE
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Credential | DO
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Telephone | 631-422-0852
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 182693
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License Number State | NY
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