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General NPI Number Information
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NPI Number | 1205033560
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Entity Type | Organization
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Legal Business Name | ARLENE BONAPACE
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Dates
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Enumeration Date | 06/29/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 764 EASTON AVE SUITE 2
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City | SOMERSET
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State | NJ
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Zip | 08873-1856
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Country | US
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Telephone | 732-418-1122
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Fax | 732-937-8081
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Provider Business Mailing Address
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Address Line | 764 EASTON AVE SUITE 2
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City | SOMERSET
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State | NJ
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Zip | 08873-1856
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Country | US
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Telephone | 732-418-1122
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Fax | 732-937-8081
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | ARLENE BONAPACE
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Credential | PSYD
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Telephone | 732-418-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 35SI00312000
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License Number State | NJ
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