Provider Demographics
NPI:1831503309
Name:BONSEY, THERESA MARIE (RPH, MPH, BCPS)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARIE
Last Name:BONSEY
Suffix:
Gender:F
Credentials:RPH, MPH, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MEDICAL CENTER PARKWAY
Mailing Address - Street 2:ALFOND CENTER FOR HEALTH
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8060
Mailing Address - Country:US
Mailing Address - Phone:207-873-0634
Mailing Address - Fax:207-621-9333
Practice Address - Street 1:73 OAKLAND ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5240
Practice Address - Country:US
Practice Address - Phone:207-873-0634
Practice Address - Fax:207-621-9333
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPR38711835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy