Provider Demographics
NPI:1255437190
Name:BONSKY, ANDREW (PA)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:BONSKY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10935 HUNTINGTON CLOSE
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-1700
Mailing Address - Country:US
Mailing Address - Phone:216-215-2197
Mailing Address - Fax:440-446-7878
Practice Address - Street 1:6300 WILSON MILLS RD
Practice Address - Street 2:
Practice Address - City:MAYFIELD VILLAGE
Practice Address - State:OH
Practice Address - Zip Code:44143-2109
Practice Address - Country:US
Practice Address - Phone:440-395-2030
Practice Address - Fax:440-446-7878
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-00-0851363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant