Individual
RICHARD J BONFORTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 BALDWIN AVE, JERSEY CITY, NJ 07304-3154
(201) 714-7903
Mailing address
PO BOX 334, WAYNE, NJ 07474-0334
(201) 804-2800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
25MA02228700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00163557
—
NJ
Enumeration date
06/27/2005
Last updated
07/08/2007
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