Provider Demographics
NPI:1134601917
Name:BONELLI, ANNA (DOCTOR OF PHARMACY)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:BONELLI
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 SHAKER CT
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-1256
Mailing Address - Country:US
Mailing Address - Phone:203-453-1734
Mailing Address - Fax:
Practice Address - Street 1:22 LEETES ISLAND RD
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-6514
Practice Address - Country:US
Practice Address - Phone:203-481-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTPCT0010059183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist