Provider Demographics
NPI:1003032384
Name:BONOCORE, RALPH (DC)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:
Last Name:BONOCORE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2674
Mailing Address - Country:US
Mailing Address - Phone:973-894-3231
Mailing Address - Fax:973-894-3232
Practice Address - Street 1:17 WATCHUNG AVE
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2700
Practice Address - Country:US
Practice Address - Phone:973-635-2627
Practice Address - Fax:973-635-2646
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2008-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00641800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ088317Medicare PIN