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NPI Code Detail

MEDICARE: FRANK DANIEL BUONO MS

MEDICARE: FRANK DANIEL BUONO MS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1225386360
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRANK DANIEL BUONO MS
Provider Business Mailing Address
First Line : 2200 S ILLINOIS AVE APT 4
Second Line :
City : CARBONDALE
State : IL
Zip : 62903-5964
Country : US
Telephone Number : 618-493-7382
Fax Number : 618-493-6390
Provider Business Practice Location Address
First Line : 5601 STATE ST
Second Line :
City : EAST SAINT LOUIS
State : IL
Zip : 62203-1346
Country : US
Telephone Number : 618-213-3170
Fax Number : 618-213-3171
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2012
Last Update Date : 08/21/2012

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