MEDICARE: JUDITH E BONATCH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	FO2484	PA

General Provider Information

NPI Number	:	1962529362
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDITH E BONATCH

Provider Business Mailing Address
First Line	:	82 HILLTOP DR
Second Line	:
City	:	HOME
State	:	PA
Zip	:	15747-7114
Country	:	US
Telephone Number	:	724-397-4370
Fax Number	:

Provider Business Practice Location Address
First Line	:	141 S JEFFERSON ST
Second Line	:
City	:	KITTANNING
State	:	PA
Zip	:	16201-2409
Country	:	US
Telephone Number	:	724-548-4801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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Directions to “ JUDITH E BONATCH ” Practice Location

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