Healthcare Provider Details

I. General information

NPI: 1356528244
Provider Name (Legal Business Name): BILLIE A. BONDAR, DPM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 01/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 ROCHESTER HILL RD STE 3
ROCHESTER NH
03867-3235
US

IV. Provider business mailing address

60 ROCHESTER HILL RD STE 3
ROCHESTER NH
03867-3235
US

V. Phone/Fax

Practice location:
  • Phone: 603-332-1026
  • Fax: 603-332-7190
Mailing address:
  • Phone: 603-332-1026
  • Fax: 603-332-7190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number0219
License Number StateNH

VIII. Authorized Official

Name: BILLIE ARLENE BONDAR
Title or Position: OWNER
Credential: DPM
Phone: 603-332-1026