Dominique Premene Bonny, is a
Licensed Practical Nurse based in Mahwah, New Jersey. Dominique Premene Bonny is licensed to practice in New York (license number 306824-1) and her current practice location is
2105 Hawthorne Ln, Mahwah, New Jersey. She can be reached at her office (for appointments etc.) via phone at
(201) 783-8690.
NPI number for Dominique Premene Bonny is 1861747842 and her current mailing address is 2105 Hawthorne Ln, Mahwah, New Jersey. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1861747842.
Provider's Profile
Full Name | Dominique Premene Bonny |
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Gender | Female |
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Speciality | Licensed Practical Nurse |
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Location | 2105 Hawthorne Ln, Mahwah, New Jersey |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1861747842
- Provider Enumeration Date: 07/17/2012
- Last Update Date: 07/17/2012
Medical Identifiers
Medical identifiers for Dominique Premene Bonny such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1861747842 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 306824-1 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dominique Premene Bonny is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dominique Premene Bonny, 2105 Hawthorne Ln, Mahwah, NJ 07430-3496 Ph: (201) 783-8690 | Dominique Premene Bonny, 2105 Hawthorne Ln, Mahwah, NJ 07430-3496 Ph: (201) 783-8690 |
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