Provider Demographics
NPI:1093103384
Name:BONNIST, CARINE (ND)
Entity Type:Individual
Prefix:DR
First Name:CARINE
Middle Name:
Last Name:BONNIST
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CANFIELD XING
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06855-2837
Mailing Address - Country:US
Mailing Address - Phone:203-952-8666
Mailing Address - Fax:
Practice Address - Street 1:3 CANFIELD XING
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06855-2837
Practice Address - Country:US
Practice Address - Phone:203-952-8666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-08
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT590175F00000X
CAND700175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath