Provider Demographics
NPI:1740557842
Name:LONSBERRY, CHRISTINE (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:LONSBERRY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06029-3794
Mailing Address - Country:US
Mailing Address - Phone:860-454-0624
Mailing Address - Fax:860-454-0625
Practice Address - Street 1:149 DEMING ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1731
Practice Address - Country:US
Practice Address - Phone:860-644-1210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-18
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT08576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist