Individual
BRIDGETTE BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 PARK ST, FONDA, NY 12068-4830
(518) 853-3531
Mailing address
PO BOX 1500, FONDA, NY 12068-1500
(518) 853-3531
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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