Bongiorno, Jeffrey Joseph

Bongiorno, Jeffrey Joseph is an sole proprietor health care provider with primary practice located at 1317 W Grand Ave , Port Washington WI 53074-2075. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Bongiorno, Jeffrey Joseph can be contacted via phone (262) 284-8800.

Contact Information

Primary practice address
1317 W Grand Ave Port Washington WI 53074-2075
Phone: (262) 284-8800
Fax: (262) 284-8861
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 798025 Wisconsin

Profile Details

NPI number 1770599953
LBN Legal business name Bongiorno, Jeffrey Joseph
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 31st, 2006
Last updated Nov 19th, 2007 - about 17 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 1770599953 NPPES
Other P00085509 RR MCR
MEDICAID 41755100 RR MCR
MEDICAID 43227800 RR MCR
Other 4998210001 RR MCR

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