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Contact Information

JEFFREY J BONGIORNO, DPM
1317 W GRAND AVE
PORT WASHINGTON, WI53074-2075
 Phone: 262-284-8800
 Fax: 262-284-8861
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFREY J BONGIORNO · (Male)

NPI Number 1770599953
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 07/31/2006
Last updated 11/19/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 798025
  • WI Medicaid 41755100
  • WI Medicaid 43227800
  • Other 4998210001 DMERC
  • Other P00085509 RR MCR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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