Provider Demographics
NPI:1982268926
Name:BONNE ANNEE, CLAUDY (FNP, MD)
Entity type:Individual
Prefix:
First Name:CLAUDY
Middle Name:
Last Name:BONNE ANNEE
Suffix:
Gender:M
Credentials:FNP, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 SW SUDDER AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953
Mailing Address - Country:US
Mailing Address - Phone:413-735-3149
Mailing Address - Fax:
Practice Address - Street 1:1541 TOMLINSON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1526
Practice Address - Country:US
Practice Address - Phone:718-892-6600
Practice Address - Fax:718-892-6600
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-25
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY767064163W00000X
NY767064163W00000X
FLHSE6403207Q00000X
CA95034645363LF0000X
FLAPRN11014614363LF0000X
AZ320419363LP2300X
NYF348961-01363LP2300X
AZ320418363LP2300X
NY406944363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYMB9773121OtherDEA
NYMB9773121Medicaid