Individual
MRS. BONNIE JEAN MATACALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
25 ELLAS AVE, BATH, NY 14810-1107
(607) 776-4110
(607) 776-6873
Mailing address
25 ELLAS AVE, BATH, NY 14810-1107
(607) 776-4110
(607) 776-6873
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
195588-1
NY
Other
Enumeration date
11/16/2011
Last updated
11/30/2011
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