Bonilla, Melissa

Bonilla, Melissa is an individual health care provider with primary practice located at 60 West Main Street , Freehold NJ 07728. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Bonilla, Melissa can be contacted via phone (732) 409-3633.

Contact Information

Primary practice address
60 West Main Street Freehold NJ 07728
Fax: (732) 409-7133
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 233173 New York
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 25MA08165700 New Jersey

Profile Details

NPI number 1922106087
LBN Legal business name Bonilla, Melissa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jan 13th, 2011 - about 13 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 1922106087 NPPES
New Jersey MEDICAID 0120995

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