MS. CAROLINE MARIE BONFANTI


Address: 24 Winnipeg Ln, Lawrence, NJ 08648-4119
Phone: 6093348096

MS. CAROLINE MARIE BONFANTI (NPI# 1619308731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1619308731
Entity Type Individual
Full Name MS. CAROLINE MARIE BONFANTI
Credential PMHNP
Practice Address 24 Winnipeg Ln
Lawrence
NJ 08648-4119
Mailing Address 1625 Schrader Blvd
Los Angeles
CA 90028-6213
Practice Telephone 6093348096
Mailing Telephone 3239937400
Enumeration Date 2013-11-30
Last Update Date 2016-06-01
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
26NJ00456300 NJ Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 24 WINNIPEG LN
City LAWRENCE
State NJ
Zip Code 08648-4119

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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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Competitor

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City LAWRENCE
Zip Code 08648

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Dataset Information

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.

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