Individual
MARIE L BONVICINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
222 OAK AVE, TOMS RIVER, NJ 08753-3348
(732) 914-1919
(732) 341-3303
Mailing address
222 OAK AVE, TOMS RIVER, NJ 08753-3348
(732) 914-1919
(732) 341-3303
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA06624300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062754000
AMERIHEALTH NJ PA DEL
NJ
01
—
010066243NJ01
ST BARNABAS HEALTH
NJ
01
—
3023421
CIGNA COMED
NJ
01
—
3023421001
CIGNA HMO
NJ
01
—
341407
AMERIHEALTH ADMIN
NJ
05
—
7653506
—
NJ
01
—
G02909
HEALTH NET PHS
NJ
01
—
P732138
OXFORD
NJ
Enumeration date
06/19/2006
Last updated
07/08/2007
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