1134371461 NPI number — MEAGHAN KATHLEEN BONIN DPT

Table of content: MEAGHAN KATHLEEN BONIN DPT (NPI 1134371461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134371461 NPI number — MEAGHAN KATHLEEN BONIN DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BONIN
Provider First Name:
MEAGHAN
Provider Middle Name:
KATHLEEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WHITE
Provider Other First Name:
MEAGHAN
Provider Other Middle Name:
KATHLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134371461
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 253
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMHERST
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03031-0253
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-249-3337
Provider Business Mailing Address Fax Number:
603-249-3387

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
199 STATE ROUTE 101
Provider Second Line Business Practice Location Address:
SUITE 5A
Provider Business Practice Location Address City Name:
AMHERST
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03031-1735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-249-3337
Provider Business Practice Location Address Fax Number:
603-249-3387
Provider Enumeration Date:
10/17/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  3367 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)