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Individual

RANDALL C BONFIGLIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5620 WILLIAM PENN HWY, MURRYSVILLE, PA 15632-9035
(412) 780-0741
Mailing address
PO BOX 248, MURRYSVILLE, PA 15668-0248
(412) 977-0980
(724) 387-1033

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301091328
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0019122100001
PA
Enumeration date
08/09/2006
Last updated
02/26/2013
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