Provider Demographics
NPI:1114177755
Name:LANZILLOTTA, BONNIE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:BONNIE
Middle Name:
Last Name:LANZILLOTTA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-2748
Mailing Address - Country:US
Mailing Address - Phone:781-351-0193
Mailing Address - Fax:
Practice Address - Street 1:656 BROADWAY
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2748
Practice Address - Country:US
Practice Address - Phone:781-351-0193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-19
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula