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1215925862 NPI number — KATHLEEN BUONOMO CRNA

NPI Number: 1215925862
Health Care Provider/Practitioner: KATHLEEN BUONOMO CRNA

Information about “1215925862” NPI (KATHLEEN BUONOMO CRNA) exists in 1215925862 in HTML format HTML  |  1215925862 in plain Text format TXT  |  1215925862 in PDF (Portable Document Format) PDF  |  1215925862 in an XML format XML  formats.

NPI Number : 1215925862 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215925862",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BUONOMO",
    "FirstName": "KATHLEEN",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "CRNA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "333 N OXFORD VALLEY RD",
    "SecondLineMailingAddress": "STE 510",
    "MailingAddressCityName": "FAIRLESS HILLS",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19030-2629",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-785-0145",
    "MailingAddressFaxNumber": "215-785-0161",
    "FirstLinePracticeLocationAddress": "2010 OLD WEST CHESTER PIKE",
    "SecondLinePracticeLocationAddress": "SUITE 330",
    "PracticeLocationAddressCityName": "HAVERTOWN",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19083-2712",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "610-789-8070",
    "PracticeLocationAddressFaxNumber": "610-789-9937",
    "EnumerationDate": "10/07/2005",
    "LastUpdateDate": "12/14/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "367500000X",
        "TaxonomyName": "Certified Registered Nurse Anesthetist",
        "LicenseNumber": "RN246195L",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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