Provider Demographics
NPI:1205549508
Name:BONTE, ANGELINA
Entity type:Individual
Prefix:
First Name:ANGELINA
Middle Name:
Last Name:BONTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-4739
Mailing Address - Country:US
Mailing Address - Phone:908-235-6255
Mailing Address - Fax:
Practice Address - Street 1:60 OLD NEW MILFORD RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:CT
Practice Address - Zip Code:06804-2430
Practice Address - Country:US
Practice Address - Phone:203-775-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-02
Last Update Date:2023-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical