Provider Demographics
NPI:1457857724
Name:TONZI, MOLLY MARIA
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:MARIA
Last Name:TONZI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 MELROSE RD APT 2E
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-9272
Mailing Address - Country:US
Mailing Address - Phone:315-406-5693
Mailing Address - Fax:
Practice Address - Street 1:1275 STATE ROUTE 5 LOT 316
Practice Address - Street 2:
Practice Address - City:ELBRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13060-9685
Practice Address - Country:US
Practice Address - Phone:315-406-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY323182164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse