Provider Demographics
NPI:1457423493
Name:BUONOPANE, ALESSANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALESSANDRA
Middle Name:
Last Name:BUONOPANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 WARMINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-1512
Mailing Address - Country:US
Mailing Address - Phone:203-631-9201
Mailing Address - Fax:203-654-3018
Practice Address - Street 1:246 WOLCOTT RD
Practice Address - Street 2:
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2641
Practice Address - Country:US
Practice Address - Phone:203-879-3230
Practice Address - Fax:203-654-3018
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2018-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0394232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCBHP2017ABMedicaid
CT001394238Medicaid