Provider Demographics
NPI:1750433827
Name:BONINO, PAULA (MD)
Entity type:Individual
Prefix:DR
First Name:PAULA
Middle Name:
Last Name:BONINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:120 5TH AVE
Mailing Address - Street 2:SUITE P5101
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3000
Mailing Address - Country:US
Mailing Address - Phone:412-544-1931
Mailing Address - Fax:412-544-1971
Practice Address - Street 1:120 5TH AVE
Practice Address - Street 2:SUITE P5101
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3000
Practice Address - Country:US
Practice Address - Phone:412-544-1931
Practice Address - Fax:412-544-1971
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD044417E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A13979Medicare UPIN