Individual
ERICA BONAVITACOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-5176
(215) 829-3000
Mailing address
800 SPRUCE ST, PHILADELPHIA, PA 19107-5176
(215) 829-3000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA058908
PA
Other
Enumeration date
05/01/2017
Last updated
11/14/2018
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