Provider Demographics
NPI:1043025794
Name:BONASERA, BRITTANY (PHD)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:BONASERA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 VERONA PL
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2735
Mailing Address - Country:US
Mailing Address - Phone:516-880-3803
Mailing Address - Fax:
Practice Address - Street 1:500 N BROADWAY STE 215
Practice Address - Street 2:
Practice Address - City:JERICHO
Practice Address - State:NY
Practice Address - Zip Code:11753-2145
Practice Address - Country:US
Practice Address - Phone:516-719-6383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist