Provider Demographics
NPI:1356528244
Name:BILLIE A. BONDAR, DPM
Entity type:Organization
Organization Name:BILLIE A. BONDAR, DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:ARLENE
Authorized Official - Last Name:BONDAR
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:603-332-1026
Mailing Address - Street 1:60 ROCHESTER HILL RD
Mailing Address - Street 2:STE 3
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-3235
Mailing Address - Country:US
Mailing Address - Phone:603-332-1026
Mailing Address - Fax:603-332-7190
Practice Address - Street 1:60 ROCHESTER HILL RD
Practice Address - Street 2:STE 3
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-3235
Practice Address - Country:US
Practice Address - Phone:603-332-1026
Practice Address - Fax:603-332-7190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0219213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH0490990001Medicare NSC