Individual
MR. JASON BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1250 WATERS PLACE SUITE 501, BRONX, NY 10461
(718) 409-9444
(718) 409-0236
Mailing address
1250 WATERS PLACE SUITE 501, BRONX, NY 10461
(718) 409-9444
(718) 409-0236
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
024053
NY
Other
Enumeration date
11/23/2010
Last updated
11/23/2010
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