Organization
PREMIER PEDIATRIC CARDIOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BONNEY M.D. (CEO)
(856) 872-2868
Entity
Organization
Contact information
Practice address
750 ROUTE 73 S, MARLTON, NJ 08053-4141
(856) 872-2868
(856) 872-2876
Mailing address
333 E LANCASTER AVE, #334, WYNNEWOOD, PA 19096-1929
(856) 872-2868
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
25MA08663900
NJ
2080P0202X
Pediatric Cardiology Physician
MD436538
PA
Other
Enumeration date
04/09/2016
Last updated
10/20/2016
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