Bonita, Raphael Edward

Bonita, Raphael Edward is an sole proprietor health care provider with primary practice located at 925 Chestnut St Mezzanine Level, Philadelphia PA 19107-4216. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Bonita, Raphael Edward can be contacted via phone (215) 955-5050.

Contact Information

Primary practice address
925 Chestnut St Mezzanine Level Philadelphia PA 19107-4216
Phone: (215) 955-5050
Fax: (215) 955-1174
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X MD428378 Pennsylvania

Profile Details

NPI number 1790973147
LBN Legal business name Bonita, Raphael Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2007
Last updated Mar 22nd, 2017 - about 8 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 1790973147 NPPES
Pennsylvania MEDICAID 1024344320001
Pennsylvania MEDICAID 0225088

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