1245739192 NPI number — MRS. ROBIN BONNER M.S., CCC-SLP

Table of content: MRS. ROBIN BONNER M.S., CCC-SLP (NPI 1245739192)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245739192 NPI number — MRS. ROBIN BONNER M.S., CCC-SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BONNER
Provider First Name:
ROBIN
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC-SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOLINO
Provider Other First Name:
ROBIN
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1245739192
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
514 KIRKWALL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08094-2912
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-221-4179
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 EGG HARBOR RD STE H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08080-9404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-432-3032
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2018

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: 235Z00000X , with the licence number:  41YS00933500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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