Individual
DINO R BONI JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1953 BRUSH RUN RD, AVELLA, PA 15312-2004
(304) 233-9314
(304) 233-0265
Mailing address
1953 BRUSH RUN RD, AVELLA, PA 15312-2004
(304) 233-9314
(304) 233-0265
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12108
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3002778000
—
WV
Enumeration date
06/22/2005
Last updated
05/12/2008
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