Individual
MARLENE BONILLA ALICEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
1016
MN
213E00000X
Podiatrist
N006419-1
NY
Other
Enumeration date
08/14/2007
Last updated
04/12/2023
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