Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bonny Zuckerberg

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790323830

Bonny Zuckerberg is a Physician Assistant in Far Rockaway, New York. Qualified in 2021, 5 years ago. Practices as a sole proprietor.

Years since qualifying
5
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1116 Neilson St
Far Rockaway, NY 11691-4720
Phone: (917) 692-6864
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1790323830
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedDecember 19, 2019
Last updated in NPPESMay 24, 2022
Certification dateMay 24, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Far Rockaway