Provider Demographics
NPI:1831286764
Name:SAUNDERS, BONNIE ELAINE (PT)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:ELAINE
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 JEFFERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3539
Mailing Address - Country:US
Mailing Address - Phone:908-456-0111
Mailing Address - Fax:
Practice Address - Street 1:3 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5037
Practice Address - Country:US
Practice Address - Phone:609-655-4200
Practice Address - Fax:609-655-4201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00895600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist