Provider Demographics
NPI:1033448204
Name:DECAIRES, BONU (CD(DONA), CCE)
Entity Type:Individual
Prefix:
First Name:BONU
Middle Name:
Last Name:DECAIRES
Suffix:
Gender:F
Credentials:CD(DONA), CCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 WALNUT ST APT 2
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-4900
Mailing Address - Country:US
Mailing Address - Phone:845-313-1151
Mailing Address - Fax:
Practice Address - Street 1:59 WALNUT ST APT 2
Practice Address - Street 2:
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-4900
Practice Address - Country:US
Practice Address - Phone:845-313-1151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula