Basic Information
Provider Information
NPI: 1093769366
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DESCHNER
FirstName: BONNIE
MiddleName:  
NamePrefix: MISS
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 68 S. SERVICE RD.
Address2: STE 350
City: MELVILLE
State: NY
PostalCode: 117472358
CountryCode: US
TelephoneNumber: 5169453107
FaxNumber: 5169453131
Practice Location
Address1: 618 HOSPITAL RD
Address2: RIVERSIDE TAPPAHANNOCK HOSPITAL
City: TAPPAHANNOCK
State: VA
PostalCode: 225605000
CountryCode: US
TelephoneNumber: 8044433311
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/20/2006
LastUpdateDate: 03/13/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X0101235576VAY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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