Individual
MS. CAROLINE MARIE BONFANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
24 WINNIPEG LN, LAWRENCE, NJ 08648-4119
(609) 334-8096
Mailing address
1625 SCHRADER BLVD, LOS ANGELES, CA 90028-6213
(323) 993-7400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
F401818-01
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
26NJ00456300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
11/30/2013
Last updated
01/14/2022
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