Individual
DR. MELISSA BONILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
60 WEST MAIN STREET, FREEHOLD, NJ 07728
(732) 409-3633
(732) 409-7133
Mailing address
69 W MAIN ST, FREEHOLD, NJ 07728-2114
(732) 409-3633
(732) 409-7133
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
233173
NY
208000000X
Pediatrics Physician
Primary
25MA08165700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120995
—
NJ
Enumeration date
09/20/2006
Last updated
01/13/2011
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