Provider Demographics
NPI:1750315610
Name:D'ONOFRIO, MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:D'ONOFRIO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 COLUMBUS BLVD
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06103-1801
Mailing Address - Country:US
Mailing Address - Phone:860-874-8430
Mailing Address - Fax:860-702-5063
Practice Address - Street 1:450 COLUMBUS BLVD
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06103-1801
Practice Address - Country:US
Practice Address - Phone:860-874-8430
Practice Address - Fax:860-702-5062
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003407363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner