Organization
BONSALL MANFREDI & ASSOC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC K. BONSALL M.D. (BOARD CERTIFIED CHILD/ADOLESCENT PS)
(717) 221-0711
Entity
Organization
Contact information
Practice address
2600 WOODLAWN STREET, HARRISBURG, PA 17111
(717) 221-0711
(717) 221-0435
Mailing address
5A MELRON COURT, CARLISLE, PA 17013
(717) 221-0711
(717) 221-0435
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD036799E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1210002
—
PA
Enumeration date
12/20/2011
Last updated
12/20/2011
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