Provider Demographics
NPI:1164598801
Name:BONO, JAMES VINCENT (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:VINCENT
Last Name:BONO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:125 PARKER HILL AVE
Mailing Address - Street 2:#573
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02120
Mailing Address - Country:US
Mailing Address - Phone:617-754-5901
Mailing Address - Fax:617-566-2257
Practice Address - Street 1:125 PARKER HILL AVE
Practice Address - Street 2:#573
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02120
Practice Address - Country:US
Practice Address - Phone:617-754-5901
Practice Address - Fax:617-566-2257
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79297207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
733745OtherTUFTS HEALTH PLAN
171504OtherHARVARD PILGRIM
J30573Medicare ID - Type Unspecified
733745OtherTUFTS HEALTH PLAN