Individual
CORY J BONGIVENGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 NORTHWEST AVE # A-120, TALLMADGE, OH 44278-1808
(330) 633-4187
Mailing address
30 NORTHWEST AVE # A-120, TALLMADGE, OH 44278-1808
(330) 633-4187
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/20/2019
Last updated
12/12/2025
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