Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

St Bonaventure University

Organization Orthopaedic Surgery Physician · NPI 1710407945

St Bonaventure University is an Orthopaedic Surgery Physician in Saint Bonaventure, New York. Licensed in New York. Registered with an NPI since 2017.

Licensed in
NY
In the registry since
2017

Practice location Address checks out

3261 W State Rd
Saint Bonaventure, NY 14778-9800
Phone: (972) 367-4845
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 211943-2 (NY)

Record details

NPI number1710407945
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mouzon Bass — Agent · (972) 367-4845
Other names St. Bonaventure Sports Medicine
NPI enumeratedJune 20, 2017
Last updated in NPPESJune 20, 2017
Mailing address5050 Spring Valley Rd, Dallas, TX 75244-3995