Individual
LUCA BONOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
368 ROOSEVELT ST, FAIRVIEW, NJ 07022-1716
(201) 421-7659
Mailing address
368 ROOSEVELT ST, FAIRVIEW, NJ 07022-1716
(201) 421-7659
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
44SL06725200
NJ
Other
Enumeration date
08/09/2024
Last updated
08/09/2024
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