| Lisa M. Bonaventura, M.d., P.a. | |
|
2345 Lamington Rd Suite 104 Bedminster NJ 07921-2612 | |
| (908) 781-9661 | |
| (908) 781-2106 |
| Full Name | Lisa M. Bonaventura, M.d., P.a. |
|---|---|
| Speciality | Internal Medicine |
| Location | 2345 Lamington Rd, Bedminster, New Jersey |
| Authorized Official Name and Position | Lisa M. Bonaventura (P.A. PHYSICIAN/OWNER) |
| Authorized Official Contact | 9087819661 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lisa M. Bonaventura, M.d., P.a. 2345 Lamington Rd Suite 104 Bedminster NJ 07921-2612 Ph: (908) 781-9661 | Lisa M. Bonaventura, M.d., P.a. 2345 Lamington Rd Suite 104 Bedminster NJ 07921-2612 Ph: (908) 781-9661 |
| NPI Number | 1184721227 |
|---|---|
| Provider Enumeration Date | 09/20/2006 |
| Last Update Date | 01/12/2010 |
| Medicare PECOS PAC ID | 4082750310 |
|---|---|
| Medicare Enrollment ID | O20090930000170 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184721227 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MA51694 (New Jersey) | Primary |
| Provider Name | Lisa M Bonaventura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497850895 PECOS PAC ID: 1355367699 Enrollment ID: I20051017000660 |
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