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General NPI Number Information
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NPI Number | 1477495638
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Entity Type | Individual
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Provider Name | NICHOLAS STEPHEN BONAMASE CAA
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Gender | Male
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Dates
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Enumeration Date | 04/07/2026
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Last Update Date | 04/07/2026
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Provider Practice Location Address
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Address Line | 4135 BOARDMAN CANFIELD RD
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City | CANFIELD
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State | OH
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Zip | 44406-9803
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Country | US
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Telephone | 330-286-5330
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Fax |
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Provider Business Mailing Address
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Address Line | 1699 COLLAR PRICE RD
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City | HUBBARD
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State | OH
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Zip | 44425-2920
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Country | US
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Telephone | 234-380-2164
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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 | 367H00000X
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Taxonomy Name | Anesthesiologist Assistant
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License Number |
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License Number State | OH
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