MARIE SUSAN BONAVOGLIA (NPI# 1245540731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245540731 |
| Entity Type | Individual |
| Full Name | MARIE SUSAN BONAVOGLIA |
| Other Name | MARIE SUSAN GILLETTE |
| Credential | PA-C |
| Practice Address |
1500 Main St Dickson City PA 18447-1343 |
| Mailing Address |
228 February Dr Scranton PA 18505-4356 |
| Practice Telephone | 5704898940 |
| Practice Fax Number | 5704893445 |
| Mailing Telephone | 5703442097 |
| Enumeration Date | 2010-10-18 |
| Last Update Date | 2011-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
MA052473 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1500 MAIN ST |
| City | DICKSON CITY |
| State | PA |
| Zip Code | 18447-1343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629695853 | Dean Eleftherakis | Acupuncturist | 503 Sunset Dr., Dickson City, PA 18447 | 2020-07-03 |
| 1881838969 | Physical Therapy Advantage, LLC | Specialist | 1446 E Lackawanna Ave, Olyphant, PA 18447 | 2009-04-21 |
| 1689846529 | William John Morris | Dentist | 112 Delaware Ave, Olyphant, PA 18447 | 2008-04-01 |
| 1386856664 | Cara Marie Koslow | Counselor | 1714 Main St, Blakely, PA 18447 | 2007-05-07 |
| 1760607204 | Mariel Gazmen Carino | General Practice | 117 Susquehanna Ave, Olyphant, PA 18447 | 2007-04-17 |
| 1194883850 | Jason Patrick Yusavage | Chiropractor | 514 Burke By-pass, Olyphant, PA 18447 | 2006-12-05 |
| 1477549855 | Lackawanna County Employees | Skilled Nursing Facility | Sturges Road, Olyphant, PA 18447 | 2005-09-21 |
| 1164927695 | Emilia Ivanova Slavova | Nurse Practitioner | 1619 Main Street, Olyphant, PA 18447 | 2018-03-27 |
| 1134536535 | Geisinger Clinic | Family Medicine | 221 River St, Olyphant, PA 18447 | 2014-07-17 |
| 1326485020 | Geisinger Clinic | Internal Medicine | 1500 Main Street, Dickson City, PA 18447 | 2013-06-04 |
| Find all providers in zip 18447 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386628691 | Aaron Center, Inc. | Physician Assistant | 851 Commerce Blvd, Dickson City, PA 18519-1677 | 2005-11-30 |
| 1356779086 | Shawna Perry | Physician Assistant | 334 Main St, Dickson City, PA 18519-1668 | 2013-10-15 |
| 1992056576 | Ashley Dommes | Physician Assistant | 334 Main St, Dickson City, PA 18519-1769 | 2012-09-24 |
| 1740550680 | Dawn Rose Strong | Physician Assistant | 920 Viewmont Dr, Dickson City, PA 18519-1664 | 2012-01-10 |
| 1134453954 | Ashley Marie Romanko | Physician Assistant | 334 Main St, Dickson City, PA 18519-1668 | 2009-09-25 |
| 1972647501 | Joelle L Muggeo | Physician Assistant | 334 Main St, Dickson City, PA 18519-1668 | 2007-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497355341 | Julia Majewicz Wilson | Physician Assistant | 111 Pa-715, #102, Brodheadsville, PA 18322 | 2020-10-29 |
| 1417557273 | Jared Michael Yon | Physician Assistant | 902 Dale Ave, Bradfordwoods, PA 15015-1236 | 2020-10-29 |
| 1295335230 | Jillian Ann Korgeski | Physician Assistant | 400 Corner St, Dunmore, PA 18512-2348 | 2020-10-29 |
| 1821697376 | Sidney Patel | Physician Assistant | 1834 Oregon Pike Ste 20, Lancaster, PA 17601-6463 | 2020-10-25 |
| 1629677356 | Jason Christopher Takacs Jr. | Physician Assistant | 510 Stockton Rdg, Cranberry Township, PA 16066-2280 | 2020-10-23 |
| 1467051763 | Molly Catherine Peters | Physician Assistant | 4338 Boone St, Philadelphia, PA 19128-4901 | 2020-10-19 |
| 1508465840 | Tran Quyen Tran | Physician Assistant | 2941 Hillside Rd, Broomall, PA 19008-1304 | 2020-10-19 |
| 1275132656 | Jessica Haley Stecklein | Physician Assistant | 696 Fir Ave, Langhorne, PA 19047-5450 | 2020-10-18 |
| 1083212625 | Kele Ferreira | Physician Assistant | 1201 Sandhill Rd, Lebanon, PA 17046-1943 | 2020-10-15 |
| 1386251619 | Nicholas James Lazorka | Physician Assistant | 195 Chapmans Round Top Rd, Montoursville, PA 17754-7508 | 2020-09-30 |
| Find all providers with the same taxonomy | ||||
| City | DICKSON CITY |
| Zip Code | 18447 |
Please comment or provide details below to improve the information on MARIE SUSAN BONAVOGLIA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.