Provider Demographics
NPI:1598992083
Name:BON, STEPHEN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:BON
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23 S SPINNAKER DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-1523
Mailing Address - Country:US
Mailing Address - Phone:609-296-0944
Mailing Address - Fax:609-296-0944
Practice Address - Street 1:595 E BAY AVE
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3324
Practice Address - Country:US
Practice Address - Phone:609-597-4111
Practice Address - Fax:609-597-3875
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-11
Last Update Date:2009-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01522600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist