Provider Demographics
NPI:1164168837
Name:EASTPOINTE MEDICAL LLC
Entity Type:Organization
Organization Name:EASTPOINTE MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BONNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:848-488-2200
Mailing Address - Street 1:2391 HIGHWAY 36
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC HIGHLANDS
Mailing Address - State:NJ
Mailing Address - Zip Code:07716-2532
Mailing Address - Country:US
Mailing Address - Phone:848-488-2200
Mailing Address - Fax:732-872-1508
Practice Address - Street 1:2391 HIGHWAY 36
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-2532
Practice Address - Country:US
Practice Address - Phone:732-872-6595
Practice Address - Fax:732-872-1508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-06
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty