Healthcare Provider Details

I. General information

NPI: 1801078068
Provider Name (Legal Business Name): JAMES V. BONO, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2007
Last Update Date: 11/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE SUITE 573
ROXBURY CROSSING MA
02120-2847
US

IV. Provider business mailing address

91 STILES RD
SALEM NH
03079-2846
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-6337
  • Fax:
Mailing address:
  • Phone: 800-927-0002
  • Fax: 603-893-8886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number
License Number StateMA

VIII. Authorized Official

Name: JAMES V. BONO
Title or Position: PRESIDENT
Credential: MD
Phone: 617-731-6337