Organization Active NPI

Arlene Bonapace

  • Clinical Psychologist
  • Somerset, NJ
National Provider Identifier
1205033560
Registry record updated Dec 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
35SI00312000 Issued in NJ
Legal business name
ARLENE BONAPACE
Practice address
764 Easton Ave
Suite 2
Somerset, NJ 08873-1856
Phone
(732) 418-1122
Fax
(732) 937-8081
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Arlene Bonapace, PSYDNPI 1619002094
Title
Clinical Psychologist
Phone
(732) 418-1122

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 35SI00312000 NJ Primary

Addresses

Primary practice location

764 Easton Ave
Suite 2
Somerset, NJ 08873-1856

Mailing address

764 Easton Ave
Suite 2
Somerset, NJ 08873-1856
Phone (732) 418-1122

Other identifiers 1

IdentifierTypeStateIssuer
1619002094OtherNJINDIVIDUAL NPI #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071107000029 NJ Part B Supplier - Clinic/Group Practice 2163519257 Receives reassigned benefits from 1 practitioner
Practice locations: Somerset, NJ

National Provider Directory

National Provider Directory

Locations

764 Easton Ave
Ste 2
Somerset, NJ 08873
Phone (732) 339-9886

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196899200000",
    "number": "1205033560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 EASTON AVE",
            "address_2": "SUITE 2",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731856",
            "telephone_number": "732-418-1122",
            "fax_number": "732-937-8081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 EASTON AVE",
            "address_2": "SUITE 2",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731856",
            "telephone_number": "732-418-1122",
            "fax_number": "732-937-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARLENE BONAPACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2007-12-06",
        "status": "A",
        "authorized_official_last_name": "BONAPACE",
        "authorized_official_first_name": "ARLENE",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "732-418-1122",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00312000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1619002094",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerset, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.