Mackool, Bonnie Teresa
Mackool, Bonnie Teresa is an individual health care provider with primary practice located at 50 Staniford St Suite 200, Boston MA 02114-2517. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Mackool, Bonnie Teresa can be contacted via phone (617) 726-2914.Contact Information
Primary practice address
50 Staniford St Suite 200
Boston MA 02114-2517
Phone: (617) 726-2914
Fax: (617) 724-2135
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 76647 | Massachusetts |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | G81270 | California |
Profile Details
| NPI number | 1114999000 |
|---|---|
| LBN Legal business name | Mackool, Bonnie Teresa |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 3rd, 2006 |
| Last updated | Nov 30th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114999000 | NPPES |
| Massachusetts | MEDICAID | 3107621 | |
| Massachusetts | Other | J13548 | |
| Massachusetts | Other | 729619 |
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