Provider Demographics
NPI:1114994647
Name:BUNDONIS, JOANNE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:BUNDONIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 LONG HILL RD
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07933-1318
Mailing Address - Country:US
Mailing Address - Phone:908-604-4264
Mailing Address - Fax:
Practice Address - Street 1:7 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-1221
Practice Address - Country:US
Practice Address - Phone:973-751-0200
Practice Address - Fax:973-751-4635
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJQAO6899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist