Provider Demographics
NPI:1578320263
Name:BONAFE, MAGDALENA
Entity Type:Individual
Prefix:
First Name:MAGDALENA
Middle Name:
Last Name:BONAFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1005 KAIOPUA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-5018
Mailing Address - Country:US
Mailing Address - Phone:808-295-4760
Mailing Address - Fax:808-312-4031
Practice Address - Street 1:91-1005 KAIOPUA ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-5018
Practice Address - Country:US
Practice Address - Phone:808-295-4760
Practice Address - Fax:808-312-4031
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No376K00000XNursing Service Related ProvidersNurse's Aide