Healthcare Provider Details

I. General information

NPI: 1801594551
Provider Name (Legal Business Name): MICHAEL BONDAR PMHNP, NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 S CLINTON ST
DOYLESTOWN PA
18901-4220
US

IV. Provider business mailing address

10 S CLINTON ST
DOYLESTOWN PA
18901-4220
US

V. Phone/Fax

Practice location:
  • Phone: 267-614-1313
  • Fax:
Mailing address:
  • Phone: 267-614-1313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberSP027337
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN695003
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR22393400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: