Bongalos, Jr., Ciriaco G.

Bongalos, Jr., Ciriaco G. is an sole proprietor health care provider with primary practice located at 1025 S Governors Ave , Dover DE 19904-6901. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bongalos, Jr., Ciriaco G. can be contacted via phone (302) 734-9150.

Contact Information

Primary practice address
1025 S Governors Ave Dover DE 19904-6901
Phone: (302) 734-9150
Fax: (302) 734-3931
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C10001931 Delaware

Profile Details

NPI number 1174585954
LBN Legal business name Bongalos, Jr., Ciriaco G.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 5th, 2006
Last updated Nov 24th, 2009 - about 15 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 1174585954 NPPES
Delaware MEDICAID 0000088201
Delaware Other 26436
Delaware Other AETNA

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