Individual
ALAN BOONIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
176 N MAIN ST, SHAVERTOWN, PA 18708-1121
(570) 675-0900
(570) 674-8912
Mailing address
610 WYOMING AVE, KINGSTON, PA 18704-3702
(570) 288-5441
(570) 288-5842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD021278E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000845875
—
PA
Enumeration date
06/26/2006
Last updated
11/22/2021
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