Individual provider · Type 1 NPI
Mary M. Bonomo, P.A.
Surgical Physician Assistant · Philadelphia, PA
NPI number
1376861690
Active
Practice location
5501 Old York Rd, Klein 510
Philadelphia, PA 19141-3018
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | MA051566 (PA) |
Surgical Physician Assistant: Definition to come...
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About NPI 1376861690
Mary M. Bonomo, P.A.'s National Provider Identifier is 1376861690, issued on May 11, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Philadelphia, PA. The record was last updated on May 11, 2010.