Provider Demographics
NPI:1487850939
Name:BOND, ELAINE J (MD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:J
Last Name:BOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:A13 CALLE 1 JARDINES
Mailing Address - Street 2:
Mailing Address - City:TRUJILLO ALTO
Mailing Address - State:PR
Mailing Address - Zip Code:00976
Mailing Address - Country:US
Mailing Address - Phone:787-755-9588
Mailing Address - Fax:
Practice Address - Street 1:A13 CALLE 1 JARDINES
Practice Address - Street 2:
Practice Address - City:TRUJILLO ALTO
Practice Address - State:PR
Practice Address - Zip Code:00976
Practice Address - Country:US
Practice Address - Phone:787-755-9588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR15653208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR100693OtherCRUZ AZUL
PR22991BOOtherTRIPLE S
PR2011286Medicaid
PR9760094OtherPREFERRED HEALTH HUMANA
PR9760094OtherPREFERRED HEALTH HUMANA
127830Medicare UPIN