Individual
BONITA PORCELLO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
535 MAIN ST, OLEAN, NY 14760-1513
(716) 376-2203
(716) 373-6632
Mailing address
535 MAIN ST, OLEAN, NY 14760-1513
(716) 376-2203
(716) 373-6632
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F300425
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01288279
—
NY
Enumeration date
07/21/2005
Last updated
07/08/2007
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