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1942439765 NPI number — ERNESTO BONDAREVSKY M.D. 207R00000X

NPI Number: 1942439765
Health Care Provider/Practitioner: ERNESTO BONDAREVSKY M.D. 207R00000X

Information about “1942439765” NPI (ERNESTO BONDAREVSKY M.D. 207R00000X) exists in 1942439765 in HTML format HTML  |  1942439765 in plain Text format TXT  |  1942439765 in PDF (Portable Document Format) PDF  |  1942439765 in an XML format XML  formats.

NPI Number : 1942439765 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1942439765",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BONDAREVSKY",
    "FirstName": "ERNESTO",
    "MiddleName": null,
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "M.D. 207R00000X",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "43 KEREN HAYESOD ST.",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "RAMAT HASHARON",
    "MailingAddressStateName": "NOT EXISTENT",
    "MailingAddressPostalCode": "47248",
    "MailingAddressCountryCode": "IL",
    "MailingAddressTelephoneNumber": "97235490442",
    "MailingAddressFaxNumber": "97235490517",
    "FirstLinePracticeLocationAddress": "43 KEREN HAYESOD ST.",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "RAMAT HASHARON",
    "PracticeLocationAddressStateName": "NOT EXISTENT",
    "PracticeLocationAddressPostalCode": "47248",
    "PracticeLocationAddressCountryCode": "IL",
    "PracticeLocationAddressTelephoneNumber": "97235490442",
    "PracticeLocationAddressFaxNumber": "97235490517",
    "EnumerationDate": "07/14/2009",
    "LastUpdateDate": "07/14/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207R00000X",
          "TaxonomyName": "Internal Medicine Physician",
          "LicenseNumber": "F4767",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "207RP1001X",
          "TaxonomyName": "Pulmonary Disease Physician",
          "LicenseNumber": "F4767",
          "LicenseNumberStateCode": "TX",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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