Individual
DIANE T BONACCORSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1903 MORGANTOWN ROAD, READING, PA 19607
(610) 777-4040
(610) 777-5575
Mailing address
1903 MORGANTOWN RD, READING, PA 19607
(610) 777-4040
(610) 777-5575
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD028741E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD028741E
STATE LICENSE NUMBER
PA
Enumeration date
10/03/2006
Last updated
02/09/2012
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