Provider Demographics
NPI:1538948302
Name:BONITATIS, JULIA
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:
Last Name:BONITATIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5473 GEDDES WAY
Mailing Address - Street 2:
Mailing Address - City:PIPERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18947-1164
Mailing Address - Country:US
Mailing Address - Phone:267-615-1643
Mailing Address - Fax:
Practice Address - Street 1:6542 LOGAN SQ
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-1811
Practice Address - Country:US
Practice Address - Phone:215-862-9065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-21
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP457951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist