Provider Demographics
NPI:1215925862
Name:BUONOMO, KATHLEEN (CRNA)
Entity type:Individual
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First Name:KATHLEEN
Middle Name:
Last Name:BUONOMO
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Gender:F
Credentials:CRNA
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Mailing Address - Street 1:333 N OXFORD VALLEY RD
Mailing Address - Street 2:STE 510
Mailing Address - City:FAIRLESS HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:19030-2629
Mailing Address - Country:US
Mailing Address - Phone:215-785-0145
Mailing Address - Fax:215-785-0161
Practice Address - Street 1:2010 OLD WEST CHESTER PIKE
Practice Address - Street 2:SUITE 330
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2712
Practice Address - Country:US
Practice Address - Phone:610-789-8070
Practice Address - Fax:610-789-9937
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-07
Last Update Date:2017-12-14
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Provider Licenses
StateLicense IDTaxonomies
PARN246195L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered