Provider Demographics
NPI:1548795131
Name:BONFANTI, DEBORAH (ND)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:BONFANTI
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22A ELM ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03055-4808
Mailing Address - Country:US
Mailing Address - Phone:603-721-2194
Mailing Address - Fax:
Practice Address - Street 1:31 OLD NASHUA RD STE 14
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NH
Practice Address - Zip Code:03031-2829
Practice Address - Country:US
Practice Address - Phone:603-554-1880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH130175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath