Individual
BONITA T. MANGURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
225 WARREN ST, 1ST FLOOR, NEWARK, NJ 07103-3535
(973) 972-6232
(973) 972-3832
Mailing address
30 BERGEN ST, ADMC 12 1205, NEWARK, NJ 07107-3000
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
25MA03324400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1623702
—
NJ
Enumeration date
10/03/2006
Last updated
07/14/2009
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