Mackool, Bonnie Teresa

Mackool, Bonnie Teresa is an individual health care provider with primary practice located at 50 Staniford St Suite 200, Boston MA 02114-2517. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Mackool, Bonnie Teresa can be contacted via phone (617) 726-2914.

Contact Information

Primary practice address
50 Staniford St Suite 200 Boston MA 02114-2517
Phone: (617) 726-2914
Fax: (617) 724-2135
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 76647 Massachusetts
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G81270 California

Profile Details

NPI number 1114999000
LBN Legal business name Mackool, Bonnie Teresa
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Nov 30th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114999000 NPPES
Massachusetts MEDICAID 3107621
Massachusetts Other J13548
Massachusetts Other 729619

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