Provider Demographics
NPI:1013902345
Name:HOWARD J BONENBERGER
Entity Type:Organization
Organization Name:HOWARD J BONENBERGER
Other - Org Name:ANKLE & FOOT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BONENBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-882-8866
Mailing Address - Street 1:17 RIVERSIDE ST
Mailing Address - Street 2:#205
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-1373
Mailing Address - Country:US
Mailing Address - Phone:603-882-8866
Mailing Address - Fax:603-882-8968
Practice Address - Street 1:17 RIVERSIDE ST
Practice Address - Street 2:#205
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-1373
Practice Address - Country:US
Practice Address - Phone:603-882-8866
Practice Address - Fax:603-882-8968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-13
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0181213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
RE7033Medicare ID - Type Unspecified
NH6463130001Medicare NSC
T25737Medicare UPIN
NH8260Medicare ID - Type Unspecified