Provider Demographics
NPI:1851608103
Name:BONDIMA, ANTOINE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANTOINE
Middle Name:
Last Name:BONDIMA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 58
Mailing Address - Street 2:
Mailing Address - City:CROWNPOINT
Mailing Address - State:NM
Mailing Address - Zip Code:87313-0058
Mailing Address - Country:US
Mailing Address - Phone:267-745-8589
Mailing Address - Fax:
Practice Address - Street 1:HIGHWAY JUNCTION 371 AND ROUTE 9
Practice Address - Street 2:CROWNPOINT HEALTHCARE FACILITY
Practice Address - City:CROWNPOINT
Practice Address - State:NM
Practice Address - Zip Code:87313
Practice Address - Country:US
Practice Address - Phone:505-786-6344
Practice Address - Fax:505-786-2526
Is Sole Proprietor?:No
Enumeration Date:2010-09-08
Last Update Date:2010-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00007467183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist