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General NPI Number Information
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NPI Number | 1386133049
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Entity Type | Individual
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Provider Name | RALPH JAMES BUONOPANE PH.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 30 WARREN ST UNIT 1
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City | BRIGHTON
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State | MA
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Zip | 02135-3680
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Country | US
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Telephone | 617-779-1689
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Fax | 617-779-1657
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Provider Business Mailing Address
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Address Line | 18 FLINT LOCKE LN
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City | MEDFIELD
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State | MA
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Zip | 02052-1814
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Country | US
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Telephone | 781-690-7321
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 8558
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License Number State | MA
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