Provider Demographics
NPI:1598017790
Name:BONGIORNO, HOPE STEPHANIE (MS ED, SAS)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:STEPHANIE
Last Name:BONGIORNO
Suffix:
Gender:F
Credentials:MS ED, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 BERNHARDT DR
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:NY
Mailing Address - Zip Code:14226-4724
Mailing Address - Country:US
Mailing Address - Phone:716-839-9497
Mailing Address - Fax:716-839-9497
Practice Address - Street 1:241 BERNHARDT DR
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:NY
Practice Address - Zip Code:14226-4724
Practice Address - Country:US
Practice Address - Phone:716-839-9497
Practice Address - Fax:716-839-9497
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252235891174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY252235891OtherNYSED TEACHING LISCENSE