Provider Demographics
NPI:1154397214
Name:BONNET, JEAN-PAUL (DO)
Entity type:Individual
Prefix:
First Name:JEAN-PAUL
Middle Name:
Last Name:BONNET
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 EDISON RD
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2217
Mailing Address - Country:US
Mailing Address - Phone:973-663-1300
Mailing Address - Fax:973-663-2848
Practice Address - Street 1:174 EDISON RD
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2217
Practice Address - Country:US
Practice Address - Phone:973-663-1300
Practice Address - Fax:973-663-2848
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB42670207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2006804Medicaid
NJE70274Medicare UPIN
NJ2006804Medicaid