Active NPI
Bonita T. Mangura, M.D.
- Pulmonary Disease Physician
- Newark, NJ
National Provider Identifier
1861586141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 25MA03324400
- Practice address
- 225 Warren St
1St Floor
Newark, NJ 07103-3535 - Phone
- (973) 972-6232
- Fax
- (973) 972-3832
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 25MA03324400 | NJ | Primary |
Addresses
Primary practice location
225 Warren St
1St Floor
Newark, NJ 07103-3535
Mailing address
30 Bergen St
Admc 12 1205
Newark, NJ 07107-3000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1623702 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25MA03324400 | NJ | MD | Pulmonary Disease Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1247529600000",
"number": "1861586141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 BERGEN ST",
"address_2": "ADMC 12 1205",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071073000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 WARREN ST",
"address_2": "1ST FLOOR",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071033535",
"telephone_number": "973-972-6232",
"fax_number": "973-972-3832"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGURA",
"first_name": "BONITA",
"middle_name": "T.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2009-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "NJ",
"license": "25MA03324400",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1623702",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.