Basic Information
Provider Information
NPI: 1154546562
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SARNO
FirstName: BONNIE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: APRN, BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 10 BRASS CASTLE RD
Address2:  
City: WASHINGTON
State: NJ
PostalCode: 078826309
CountryCode: US
TelephoneNumber: 9088351910
FaxNumber: 9088351924
Practice Location
Address1: 224 ROSEBERRY ST
Address2:  
City: PHILLIPSBURG
State: NJ
PostalCode: 088651687
CountryCode: US
TelephoneNumber: 9082133433
FaxNumber: 9082133647
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 07/14/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X26NN07777400NJY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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