Frederic D Bonfiglio, OPHTHALMIC DISPENSER

Primary specialty

OpticianTaxonomy code 156FX1800X

License

31TD00070800 Issued in NJ

Practice address

415 Egg Harbor Rd
Suite 14
Sewell, NJ 08080-9211

Phone

(856) 589-2929

Fax

(856) 589-5225

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1902931744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 EGG HARBOR RD",
            "address_2": "SUITE 14",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809211",
            "telephone_number": "856-589-2939",
            "fax_number": "856-589-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 EGG HARBOR RD",
            "address_2": "SUITE 14",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080809211",
            "telephone_number": "856-589-2929",
            "fax_number": "856-589-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONFIGLIO",
        "first_name": "FREDERIC",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "OPHTHALMIC DISPENSER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NJ",
            "license": "31TD00070800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Optician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.