Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CHARLES EDWARD BONFANTI, PA
DeactivatedCHARLES EDWARD BONFANTI, PA is a Physician Assistant healthcare provider located in TAOS, New Mexico. NPI 1295792570 is deactivated in the NPPES registry. Verify at CMS.
Physician Assistant · TAOS, NM
This NPI has been deactivated.
The record was deactivated on July 17, 2007.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1295792570
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 28, 2006 (1.2185792349727 yrs)
- Last Updated
- Feb 3, 2017
- Deactivated
- Jul 17, 2007
- License
-
75-PA002 (NM)
Practice Information
- Address
-
630 PASEO DEL PUEBLO SURSUITE 150TAOS, NM, 875716070Browse NM providers · Browse ZIP 87571
- Phone
- 5757583005
- Fax
- 5757587010
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in TAOS, NM
| Name | Credential | NPI |
|---|---|---|
| CHRISTINE J PERKOWSKA | PA | 1821068669 |
| CHRISTA DANELL CASTRO | PA | 1417914938 |
| DAN F THOR | PA | 1134186562 |
| MICHAEL BELLAS | PA | 1588621916 |
| MS. ELIZABETH ANNE MARTINEZ | P.A.-C | 1275681306 |
| MR. ABRAHAM THOMAS BALSAMO | P.A.-C | 1538317771 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.