Provider Demographics
NPI:1528229515
Name:BONEY, DEBRA JEAN (DIPLAC, CA)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:JEAN
Last Name:BONEY
Suffix:
Gender:F
Credentials:DIPLAC, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 N MAIN ST STE B1
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-1453
Mailing Address - Country:US
Mailing Address - Phone:609-407-6088
Mailing Address - Fax:
Practice Address - Street 1:927 N MAIN ST STE B1
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-1453
Practice Address - Country:US
Practice Address - Phone:609-407-6088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00023500171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist