Individual
CHARLES BONGIORNO
Active
Individual
CHARLES BONGIORNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD025380E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001041536
—
PA
01
—
1007278000114
MEDICAID TPI GROUP
PA
01
—
597586
MEDICARE TPI GROUP
PA
01
—
CD4829
RAILROAD MEDICARE TPI GROUP
PA
Enumeration date
03/27/2006
Last updated
03/23/2018
Update your record
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