Theresa M Bonanomi, is a
Social Worker - Clinical based in New London, Connecticut. Theresa M Bonanomi is licensed to practice in Connecticut (license number 012927) and her current practice location is
365 Montauk Ave, New London, Connecticut. She can be reached at her office (for appointments etc.) via phone at
(860) 444-5141.
NPI number for Theresa M Bonanomi is 1003365222 and her current mailing address is 365 Montauk Ave, New London, Connecticut. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003365222.
Healthcare Provider's Profile
| Full Name | Theresa M Bonanomi |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 365 Montauk Ave, New London, Connecticut |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1003365222
- Provider Enumeration Date: 09/29/2016
- Last Update Date: 05/16/2023
Medical Identifiers
Medical identifiers for Theresa M Bonanomi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1003365222 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | L10625 (Oregon) | Secondary |
| 372600000X | Adult Companion | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 012927 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Theresa M Bonanomi is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Theresa M Bonanomi, 365 Montauk Ave, New London, CT 06320-4769 Ph: (860) 444-5141 | Theresa M Bonanomi, 365 Montauk Ave, New London, CT 06320-4700 Ph: (860) 444-5141 |
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