Provider Demographics
NPI:1487807491
Name:BONNEAU, MAGALIE (LPN)
Entity type:Individual
Prefix:
First Name:MAGALIE
Middle Name:
Last Name:BONNEAU
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-16 225 STREET
Mailing Address - Street 2:PH
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11429
Mailing Address - Country:US
Mailing Address - Phone:718-776-8891
Mailing Address - Fax:
Practice Address - Street 1:95-16 225 STREET
Practice Address - Street 2:PH
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11429
Practice Address - Country:US
Practice Address - Phone:718-776-8891
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY263265164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse