Provider Demographics
NPI:1457382152
Name:BUONO CHIROPRACTIC CLINIC
Entity Type:Organization
Organization Name:BUONO CHIROPRACTIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARTOLOMEO
Authorized Official - Middle Name:
Authorized Official - Last Name:BUONO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-922-2225
Mailing Address - Street 1:4057 ASBURY AVENUE
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07753
Mailing Address - Country:US
Mailing Address - Phone:732-922-2225
Mailing Address - Fax:732-918-4746
Practice Address - Street 1:4057 ASBURY AVE
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07753-7700
Practice Address - Country:US
Practice Address - Phone:732-922-2225
Practice Address - Fax:732-918-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00563800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ044361Medicare ID - Type Unspecified