Individual
MR. JOHN MARK BUONOMO SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
446 DOMINO LANE, PHILADEPHIA, PA 19128
(215) 483-8666
(215) 483-9616
Mailing address
446 DOMINO LANE, PHILADEPHIA, PA 19128
(215) 483-8666
(215) 483-9616
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS006593-L
PA
Other
Enumeration date
06/09/2006
Last updated
04/26/2010
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