Basic Information
Provider Information
NPI: 1851626824
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HOENIG
FirstName: JOHNATHAN
MiddleName: ARYEH
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOENIG
OtherFirstName: ARYEH
OtherMiddleName:  
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 5
Mailing Information
Address1: 1434 WILLIAMSBRIDGE RD FL 2
Address2:  
City: BRONX
State: NY
PostalCode: 104612507
CountryCode: US
TelephoneNumber: 7186180401
FaxNumber:  
Practice Location
Address1: 2015 GRAND CONCOURSE
Address2:  
City: BRONX
State: NY
PostalCode: 104534303
CountryCode: US
TelephoneNumber: 7182997295
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/08/2009
LastUpdateDate: 04/07/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/07/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XA121505CAN Allopathic & Osteopathic PhysiciansPediatrics 
208000000X256113NYY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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