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General NPI Number Information
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NPI Number | 1609787993
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Entity Type | Individual
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Provider Name | ANTHONY A BOLOGNINI
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Gender | Male
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 5-05 SADDLE RIVER RD
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City | FAIR LAWN
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State | NJ
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Zip | 07410-5633
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Country | US
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Telephone | 201-429-3214
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Fax |
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Provider Business Mailing Address
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Address Line | 10 2ND ST
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City | BLOOMFIELD
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State | NJ
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Zip | 07003-2322
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Country | US
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Telephone | 201-905-4421
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 18KT00067500
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License Number State | NJ
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