| Buonomo Medical Associates Inc. | |
|
446 Domino Lane Philadelphia PA 19128 | |
| (215) 483-8666 | |
| (215) 483-9616 |
| Full Name | Buonomo Medical Associates Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 446 Domino Lane, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John Mark Buonomo (PRESIDENT) |
| Authorized Official Contact | 2154838666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Buonomo Medical Associates Inc. 446 Domino Lane Philadelphia PA 19128 Ph: (215) 483-8666 | Buonomo Medical Associates Inc. 446 Domino Lane Philadelphia PA 19128 Ph: (215) 483-8666 |
| NPI Number | 1083917801 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 12/16/2010 |
| Medicare PECOS PAC ID | 1355528159 |
|---|---|
| Medicare Enrollment ID | O20110603000253 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083917801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | John M Buonomo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619918638 PECOS PAC ID: 2961694997 Enrollment ID: I20101008001108 |
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