MATTHEW BONAVENTURE (NPI# 1104182195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104182195 |
| Entity Type | Individual |
| Full Name | MATTHEW BONAVENTURE |
| Credential | P.A-C |
| Practice Address |
75 N Hangar Rd Jamaica NY 11430-1826 |
| Mailing Address |
1253 Bernard St Valley Stream NY 11580-1419 |
| Practice Telephone | 7186569500 |
| Practice Fax Number | 7186569503 |
| Mailing Telephone | 5164776842 |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2015-06-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
016546 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
75 N HANGAR RD |
| City | JAMAICA |
| State | NY |
| Zip Code | 11430-1826 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538380944 | Wayne Charles Mccormack | Chiropractor | 75 N Hangar Rd, Suite 247, Jamaica, NY 11430-1826 | 2007-05-01 |
| 1043855448 | Angel Youssef Bakhoum | Physical Therapist | 75 N Hangar Rd, Jamaica, NY 11430-1826 | 2019-11-10 |
| 1255974200 | Keren Klaus | Acupuncturist | 75 N Hangar Rd, Jamaica, NY 11430-1826 | 2019-10-22 |
| 1811311038 | Maria Rossiello | Podiatrist | 75 N Hangar Rd, Suite 247-249, Jamaica, NY 11430-1826 | 2014-02-07 |
| 1265725972 | Hemnarine Rathibhan | Physician Assistant | 75 N Hangar Rd, Building 75, Suite 247/249 Jfk International Airport, Jamaica, NY 11430-1826 | 2011-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598380859 | Gabisa Medical Pllc | Internal Medicine | Jfk Terminal 4, Terminal 4 Arrivals West, Jamaica, NY 11430 | 2020-06-12 |
| 1861969057 | Shaneabbas Hasnain Dharsi | Preventive Medicine | Jfk International Airport Building 14, Citimedical-medport, Jamaica, NY 11430 | 2018-10-26 |
| 1649628876 | Medical Offices of Occupational Health Resources P C | Clinic/Center | Jfk International Airport, Hangar 10, Jamaica, NY 11430 | 2016-05-27 |
| 1780058750 | Ruhee Gadhia | Physician Assistant | Metro Urgent Medical Care Queens, Jfk International Airport Bldg No. 125, Jamaica, NY 11430 | 2015-11-13 |
| 1679944151 | Mary Regan | Physician Assistant | Building 125 Jfk Airport, Jamaica, NY 11430 | 2015-10-09 |
| 1306222682 | Paul Jeffrey Edelson | Pediatrics | Jfk Intl Airport-terminal4, Rm.219.016, Cdc Quarantine Station, Jamaica, NY 11430 | 2015-08-10 |
| 1417349507 | Metro Urgent Medical Care of Queens | Clinic/Center | 14-140 Jfk Tenant 4, Bldg 125, Jfk Airport, Jamaica, NY 11430 | 2015-02-26 |
| 1114335312 | Maha Komal | Physician Assistant | Jfk International Airport Bldg 14, West Wing Suite 14a, Jamaica, NY 11430 | 2014-07-31 |
| 1184921637 | John W Gimeli | Physician Assistant | 22a N. Service Road, Jamaica, NY 11430 | 2011-02-18 |
| 1871804062 | Jfk Advanced Medical PC | Clinic/Center | Jfk Airport Building 75, Suite 247/249, Jamaica, NY 11430 | 2010-06-23 |
| Find all providers in zip 11430 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548892169 | Talya Shoshani | Physician Assistant | 8321 Kent St, Jamaica, NY 11432-1525 | 2020-02-11 |
| 1073018677 | Khokon Kumar Saha | Physician Assistant | 8815 168th St Apt 1m, Jamaica, NY 11432-4305 | 2018-03-26 |
| 1003290727 | Rafael Robenov | Physician Assistant | 84-42 151st Street, Jamaica, NY 11432 | 2015-07-13 |
| 1164817052 | Hemwattie Ramnaraine | Physician Assistant | 8813 179th Pl, Jamaica, NY 11432-4735 | 2015-03-30 |
| 1184921637 | John W Gimeli | Physician Assistant | 22a N. Service Road, Jamaica, NY 11430 | 2011-02-18 |
| 1003133752 | Angelica Lyte | Physician Assistant | 14520 106th Ave, Jamaica, NY 11435-5004 | 2010-04-21 |
| 1063644557 | Frederique Jean Marie-schmitt | Physician Assistant | 16633 89th Ave, Suite 1m, Jamaica, NY 11432-4255 | 2009-08-17 |
| 1073776365 | Farzana Al Nur Flora | Physician Assistant | 15011 86th Ave, 2nd Floor, Jamaica, NY 11432-3307 | 2008-07-07 |
| 1316127293 | Harinarine Mathura | Physician Assistant | 11616 143rd St, Jamaica, NY 11436-1241 | 2007-11-08 |
| 1265509335 | Hyacinth D Gordon | Physician Assistant | 8825 153rd St Ste 4f, Jamaica, NY 11432-3748 | 2006-11-30 |
| Find all providers in JAMAICA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.