Bonanno, Joseph

Bonanno, Joseph is an individual health care provider with primary practice located at 4137 N 108Th Ave , Phoenix AZ 85037-5459. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bonanno, Joseph can be contacted via phone (623) 877-7337.

Contact Information

Primary practice address
4137 N 108Th Ave Phoenix AZ 85037-5459
Phone: (623) 877-7337
Fax: (623) 772-0686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 19131 Arizona

Profile Details

NPI number 1245234822
LBN Legal business name Bonanno, Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jun 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245234822 NPPES
Arizona MEDICAID 295974

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