Bonfiglio, Jason

Bonfiglio, Jason is an individual health care provider with primary practice located at 800 Riverside Dr , Waupaca WI 54981-1943. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Bonfiglio, Jason can be contacted via phone (715) 258-1000.

Contact Information

Primary practice address
800 Riverside Dr Waupaca WI 54981-1943
Phone: (715) 258-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1134726433
LBN Legal business name Bonfiglio, Jason
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2020
Last updated Nov 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1134726433 NPPES
Wisconsin MEDICAID 100135023

Popular Providers