Individual
BONGOFA PATRICK MATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
138 PORTSIDE CT, BEAR, DE 19701-2431
(267) 902-1606
Mailing address
138 PORTSIDE CT, BEAR, DE 19701-2431
(267) 902-1606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN2885519
PA
Other
Enumeration date
04/03/2024
Last updated
04/03/2024
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