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NPI Code Detail

MEDICARE: SAMANTHA BONDARYK PMHNP-BC

MEDICARE: SAMANTHA BONDARYK PMHNP-BC
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
1163W00000XRegistered NurseRN2280972MA
2363LP0808XPsychiatric/Mental Health Nurse PractitionerRN2280972MA

General Provider Information

NPI Number : 1508310608
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA BONDARYK PMHNP-BC
Provider Business Mailing Address
First Line : 2 GRANITE AVE
Second Line : SUITE 260
City : MILTON
State : MA
Zip : 02186-4381
Country : US
Telephone Number : 617-369-7136
Fax Number :
Provider Business Practice Location Address
First Line : 2 GRANITE AVE STE 260
Second Line :
City : MILTON
State : MA
Zip : 02186-4381
Country : US
Telephone Number : 617-369-7136
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2016
Last Update Date : 10/06/2025

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Directions to “ SAMANTHA BONDARYK PMHNP-BC” Practice Location

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